Different Piggyback Antibiotics, Same IV Tubing??

[Pinky89]

Hey all,

I just had a quick question about something I was taught in nursing school and was wondering if you learned the same thing, or practice this yourself.

You have 2 different IV piggyback antibiotics (compatible or incompatible, doesn't matter) with NSS as the primary, and one is due at 1200 and the other is due at 1800. You hang the one due at 1200 then leave everything hooked up until you come back again at 1800 when the other antibiotic is due. Instead of getting all new secondary tubing for the new antibiotic, we learned to just back prime the NSS into the piggyback line a few times to flush what's left of the 1200 antibiotic into the old antibiotic bag, then disconnect and reconnect the new antibiotic. I was told that you don't have to worry about the 2 antibiotics mixing because you back primed with NSS and all that's left is saline in the now reprimed piggyback tube.

Does anyone do this to save time and cost to the patient? Just wondering...thanks!

[Vespertinas]

Mosby's Skills instruction on how to backprime, as endorsed by my hospital:

Subsequent uses

1. Lower the mini-bag below the pump to back prime into the empty mini-bag.
   
2. Open the roller clamp.
   
3. Allow approximately 10 ml of fluid to accumulate into the empty mini-bag.
   
4. Gently squeeze the drip chamber three times in a row into the mini-bag.
   
5. Close the roller clamp.
   
6. Remove the spike and spike into the new mini-bag. Gently squeeze the drip chamber until it is 2/3 full.
   
7. Open the roller clamp and program the pump for secondary administration.
   

[edmia, BSN, RN]

At my current facility, it's written in the policy to backprime flush. You lower the completed PB bag so that it fills some with your primary fluid, close roller clamp, remove old bag, spike new bag, hang up, open roller clamp.

Primary IV lines get changed every 96 hrs. Secondary lines every 24 hrs. We label each line with the change date.

Definitely a good research study.

It makes sense to me because it diminishes the times the system is broken when you change line for each IVPB. If I did that, I'd use 15 lines a day for some patients! That's a waste of time and resources as well as increasing plastic waste in our environment.

We will have to wait for hard scientific evidence to settle this one

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