Giving iv meds through running line

nursynurseRN · Nov 24, 2012

I don't dilute if there is a running iv

Perpetual Student · Nov 24, 2012

If the fluid is compatible with the drug I always just let it keep running (often turning up the rate if it's on gravity tubing to provide further dilution). When I am done pushing the drug I draw in some fluid from the bag to use to flush it. I definitely advise not unhooking the tubing. It wastes time and every time you do it you risk contamination.

If the fluid and drug aren't compatible pause the fluid, flush, give the drug, and flush before resuming the fluid.

akulahawkRN, ADN, RN, EMT-P · Nov 24, 2012

If the fluid is compatible with the drug I always just let it keep running (often turning up the rate if it's on gravity tubing to provide further dilution). When I am done pushing the drug I draw in some fluid from the bag to use to flush it. I definitely advise not unhooking the tubing. It wastes time and every time you do it you risk contamination.
If the fluid and drug aren't compatible pause the fluid, flush, give the drug, and flush before resuming the fluid.

This. I would only add that if you're using a pump, consider it the same as if it were gravity fed. I would also do the IV Push at the port closest to the patient so that there's minimal drug in the line that still has to be flushed/pumped through the line after I'm done with pushing the med in. I would only unhook the tubing as a last resort because of potential contamination issues.

Columnist · Nov 24, 2012

Moved to Nursing and Patient Medications for more response.

eatmysoxRN, ASN, RN · Nov 24, 2012

I'd still dilute phenergan and add it to the port farthest from the patient. I actually dilute everything as I usually would when I have fluids going. Remember to pay attention to rates though. If fluids are set at kvo and you put it in the port furthest from the pt, it will take a long time to get to them and go in.

rita359 · Nov 24, 2012

I put it in the port below the filter. I always dilute meds (phenergan, narcotics etc) running fluid or not. Just make sure what you are giving is compatible with the fluid you are running. I would not disconnect the line to give the med. This would add to the risk for contamination.

Our antibiotics are in piggyback bags and are added to the port above the pump and programmed into the pump for administration. Actually, I believe that is the way it is now recommended that phenergan be given (in 50cc ns over 10-15 min). We now give more zofran than phenergan.

FORTHELOVEOF!!!! · Nov 24, 2012

When I get busy I like to use the secondary line and hook my syringe up to it and set it to run 2-5 min. Dilute based on your hospital policy or judgement call.

moorefun11 · Nov 24, 2012

I always dilute phenergan in a 50ml bag of Ns at 15min. This is to help save the possiable risk of hurting the patient and to save the site. I always dilute my narcotics cuz once it's in it's in and I have had to stop the push due to patients reactions twice. Of course at this point call the Dr. to let then know. I always give at the port closest to the patient. This is where Pca's should be hooked up also so the patient gets the maximum pain control. Then I clamp the line and then flush afterwards with 5-10 cc with the line still clamped. This was the policy at my hospital. I even had JAHCO watch me do this once with Morphine. The asked step by step questions and then stated that I was completely correct. I hope this helps. Also please give meds slow IV push. I have had patients tell me that they felt that this was better that say someone else that just pushed fast.

fiveoclocksomewhere · Nov 25, 2012

Moorefun, when you say you clamp the line, where are you clamping it at? I'm sure it would make perfect sense if I was watching you do it. So you have fluids running..you draw up your morphine (diluting it first), push it into the port closest to the patient, clamp the line, then push NS in the same port?

moorefun11 · Nov 25, 2012

Yes I just clamp it like you would a hose between 2 fingers, just above the port I'm giving the med. Then push the med over say 2 minutes(or how ever long indicated) diluted of course. I then would flush with 3ml -5 ml Ns in the same portand then unclamp. It's like your unhooking the line but not. Your pump might beep but that's ok. I also do this for line occlusions so I don't have to disconnect. Hope this helps

DachRN · Nov 25, 2012

Phenergan has to be mixed in a bag of Normal Saline, hung as Piggy Back, not pushed IV push anymore due to caustic nature of med to vein....Believe that was enacted Jan 2011 across USA. NEVER push IV meds above a pump, EVER! Push IV meds port closest to patients, if slow IV, push flush behind med. HOPE that helps.