secondary lines--question please help:)

[sweetieann]

I'm a student so please bare with me:)

So I watcheed a piggyback actually being set up for the first time at clinical. I then came across a PB skills video, and now I'm a little confused. I was used to the "traditional" PB method and that's what I was taught and saw for the first time last clinical; however on the video, the "piggyback" was simply hung at the same height as the primary and both were run at the same time (with the secondary tubing going into a second port on the patient--I've seen some patient's with multiple IV access sites). What I am confused on is: when would you hang a "traditional" piggyback (med bag above primary bag, secondary tubing going from piggyback connected to primary tubing at Y-port, back valve prevents flow of primary while PB med/solution is infusing) and when would you just infuse both primary bag and "piggyback" bag at the same time? Now that I'm confused, I'm looking into this more and wondering exactly why it is that we don't run both infusions at once (what's the point of having the primary stop while the piggyback runs in, why not run them in simultaneously if they're compatible and the patient is not CHF, renal failure, etc).

I plan on asking my instructor, but everyone on this board is so good at explaining (and besides--I'm a type A personality and can't wait till clinicals to find out the answer!:chuckle ). Any thoughts/explanations are certainly appreciated greatly! IVs terrify me!

Hope you all are having a great weekend!

[hrtprncss]

hi....lemme try to explain hmm...in regular ivpb's without pumps, you need to hang it higher than the other for the ivpb to infuse. IF you're using an IV pump, usually you can hang it at the same level because there's a built in device which would draw the fluid up from the ivpb as oppose to the primary. In response to the ''rider'' bypassing the iv pump and using another pump to infuse another bag so it consequently runs with the primary, this is done because alot of Riders need to go in slowly, therefore if you use it as a regular piggyback you would not have enough volume to infuse that patient because the primary is stopped. Riders for example are used in KCl infusions as oppose to antibiotics which is usually run as a piggyback, but of course both can be interchangeable. You can hang a KCl as a piggyback(usually 50cc/h) given if your primary IV is at 50 cc/h so you won't lose volume and more importantly, you won't push KCl faster in the vein if your primary is running at more than 100cc/h. Same thing with antibiotics, let's say you're giving Vanco which usually comes in 250cc/1gm. If you use a Rider with that, bypassing the IV pump, you would get 250 cc volume PLUS whatever your primary solution infusion rate is. Which could be used if you needed more volume for the patient. Hope that helps a bit.