Heparin

[YoungRN06]

One of my patients was on a heparin drip that was infusing through an IV pump they also had IVPB antibiotic due at the same time. I called the pharmacy and asked if the two were compatible and they said it was okay to piggyback the abx with heparin. What do I do in this situation, do I let the abx run and then restart the heparin (which just dosen't seem right to me) but I'm just not sure?

[AprilRNhere]

I wouldnt. Our pt's on abx get a second IV site.

[suzy253, RN]

Heparin runs on a dedicated line. If abx needs to be infused at the same time, another IV site needs to be established.

[queenjean]

If they were compatible, I have ran the antibiotics through another pump into the heparin line closer to the pt. Not the ideal, but sometimes you do what you gotta do. Also, plan for your next shift. If the pt might be going home soon, why not see if they can be switched to a po med a little earlier? If they are going to be there a while on several IV meds, get talking to IV therapy about an additional site or even a PICC if appropriate.

I work nights, so if I can make it work for my shift, I might not call the on call doc (who might never have seen this pt and knows nothing about him/her) to get it changed, but I will sure talk to the oncoming nurse about getting it changed and leave a note for the doc so that it's not a problem for subsequent shifts.

[rnmi2004]

As long as it's compatible you can get a second pump and Y the antibiotic into the heparin line. You shouldn't stop a heparin infusion for an antibiotic.

[SarahK73]

Our policy is that anyone on a heparin or insulin drip need to have a dedicated line and a second line for atbx.

[geekgolightly, BSN, RN]

This happened to me on Sunday. The PICC nurse put in a single line and she was an impossible stick, so I made due with running it with a separate pump and Y connected. Is there any evidence or research that shows this is dangerous or not optimal?

[iluvivt, BSN, RN]

It is important to be aware that there is a physical incompatability in which drugs combined together will have a reaction and form a precipitate and there is a chemical incombatability in which action of one or both or multiple drugs can be altered. The fact is that if all medications are compatable they can be infused together. In the situation with drips ie. heparin dopamine cardizem) I give it at site (t-extension or Y site of the catheter as in the intima catheter). If unable to do this next best is the lowest y-site on the primary tubing. Having patients with multiple IV sites for long periods of time does not help venous preservation so if long term needed get a PICC or other central line. The general rule of thumb is seven days of IV therapy....get another type of access