Published Mar 24, 2011
Nursebabe2009
28 Posts
Hi,
I am hanging antibiotics on an IV. I'm running it with normal saline. The normal saline is the primary, and the antibiotic is the secondary. For the normal saline is the rate 50 or 100 and is the volume to be infused 50 or 100? Thank you for all your help. All Nurses is a blessing.
MunoRN, RN
8,058 Posts
Although you will still find experienced nurses using the term incorrectly so please don't be offended, a "secondary" is an infusion that connects to a primary line, above the pump of the primary, and does not run "together" with the primary, but rather runs instead of the primary until the secondary infusion is complete. Running infusions together is sometimes referred to as "piggybacking" or running something into a "carrier fluid", but it's not actually a secondary.
The purpose of using a primary line with plain IVF such as NS is to prime the line prior to the ABO infusion and to then flush the line afterward, both to infuse the full dose of ABO and to flush line for the next dose.
If your patient has NS or another compatible IVF running continuously, then you would just have the pump revert back to that rate when the secondary volume has been infused. If not, you can set the primary to run for another 15-20cc's after the secondary has finished and at the same rate that the ABO was ordered to run at to flush the line, then the pump will alarm and you can clamp the line and shut off the pump. Prior to the next infusion, take the previous secondary bag, now empty, and lower the bag enough (with the secondary unclamped) for primary fluid to run back up the line and into the bag. Once enough primary fluid has flowed into the bag to clear the secondary line, lift the bag back up to stop the flow and disconnect the previous secondary bag. Your secondary line is now primed and flushed for the next secondary infusion.
#1ME
64 Posts
Our IV pumps have 'secondary' on the screen when a piggyback is infusing, so I think that terminology is fine. Anyways, to answer your question, it depends on what rate is ordered for the NS/primary IVF. The rate of the secondary infusion/piggyback depends on the antibiotic and the dosage. If the secondary is Vancomycin 250ml the rate would be 125 (a 2 hr administration), if it is Vancomycin 100ml, the rate would be 50. Usually Zosyn and Flagy could be administered in 30 min, so a rate of 200ml/hr for a volume of 100