drips connecting at y-site

Specialties MICU

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Hey Critical Care Gurus :)

It's kind of a dumb question, but I havent gotten a firm answer whenever I asked and it's always bothered me.

So lets say you have limited IV access and you have to run a vasoactive drip on the y-site of the maintenance infusion. If the drip is going 2cc/hr and the maintenance is going 100cc/hr, wont it flush the drip in at 100cc/hr if you connect it at the y-site below the pump?

I've never come into this scenario, but Im sure one day it will happen and I want to know what I should do. Im not even sure if my presumption is correct, but could someone please clarify this for me. I just cant seem to wrap my head around the concept.

Thanks in advance. I hope what Im asking is making sense to you?

Specializes in multispecialty ICU, SICU including CV.

http://www.freepatentsonline.com/7001418-0-large.jpg

This isn't an awesome pic, as to me it looks like this is actually inserted into the patient (like a quad-lumen line - is what it looks like to me.)

Anyway, a "chicken foot" is a device like that -- it has 4 lumens, all with a common entry point to the patient, and it hooks onto a single line like any IV cap would. It's basically like a big extension with 4 lumens that branch off of it.

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it's simple physics.

the reason the medication is getting there to begin with is b/c of downward pressure on the fluid (gravity). when a drip is wide open, and not on a pump, it is the gravitational pull on the fluid forcing it down through the tubing. when a fluid is on a pump, the pump is controlling when the tubing is open and it is pushing the fluid through the tubing by its own mechanism exerting force on the tubing cassette. if the pump has the tubing in a closed position, no fluids can get through it; therefore, when the pump pushes 2mL (and no more) through the tubing it is going into the base of the Y. if the base of the Y is say 3mL, no medication will reach the patient until something else pushes it in there. whether it be another 2mL push from the pump or another fluid running concurrently. when the other pump pushes its fluid down it will carry the 2mL into the vein with it. that is why it is crucial the medications be Y site compatible. hope that makes sense w/o drawing a diagram.

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The actual dose given does not change, but in my 16 years experience, I have seen them respond to "flow". For instance, if I slow my maintenance that the pressor is Y-sited to, the blood pressure dips a bit and the dose required may change.

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Specializes in MICU/SICU.
http://www.freepatentsonline.com/7001418-0-large.jpg

This isn't an awesome pic, as to me it looks like this is actually inserted into the patient (like a quad-lumen line - is what it looks like to me.)

Anyway, a "chicken foot" is a device like that -- it has 4 lumens, all with a common entry point to the patient, and it hooks onto a single line like any IV cap would. It's basically like a big extension with 4 lumens that branch off of it.

thank you! I think I get it. Your description WAS better than the pic :lol2:

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I generally don't y-site more than 2 drugs....It just gets too confusing and complicated. Stop cocks are your friend!

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Specializes in critical care, PACU.

thanks everyone for such thorough advice and responses. yes Im avoiding y-siting alltogether. the other day, I found ntg with the maintenance y-sited at it. I thought you couldnt do that at all! thank god the pt wasnt on the ntg, but when I considered starting it in the middle of the night, I followed my line and noticed and reorganized it all.

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