IV Capatibilities

Call pharmacy and ask! It's not worth taking the risk to just do it. If you can't call pharmacy, can you start a third line? Better to be safe than sorry!

Panda:

I guess that's true, always better to be safe. However this person was IVDA with NO veins, so two IV's was a miracle!

Plus they both had to be in the same arm. Suppose once he

got up to the CCU they would put in a triple-lumen groin line.

Wanted to get the first dose of antibiotics into him, but not

THAT badly....

I agree with mephispanda, when in doubt, call pharmacy. The resources that I have checked claim that they are Y-site compatible. But I would always double check with pharmacy. You never know, the antibiotic may have been incompatible.

Ack! Don't run intermittent meds through a dopamine line! You'll bolus them with the pressor, and then leave them with a line full of something else!

But wouldn't be ok to run the dopamine and lidocaine (if compatibility is ok) together, and use the second line as a maintence line for IVPB's and pushes?

Thanks guys, you've given me food for thought! I just wasn't

sure about Dopa with Lido. Seems like Dopamine is VERY

tempermental. Although it'd be great to know if this is possible,

since this scenario is likely in an ER. I like the leaving the other

line free for pushes, etc.

Thanks for the reminder about the bolus issue. Not good! I'm

really glad I didn't do ANYTHING except endorse the bag of IV

over to the ICU RN! Patient care wasn't compromised, I'm sure

she'd administer it as soon as he was settled in the unit bed,

and I didn't harm him! Just another day....:)

You could run the lido and the dopa together if they're compatible, but anything that dilutes/confuses/alters your delivery of a vasoactive drip is going to produce unpleasantness for all concerned: big changes in heart rate/BP, etc. Steady, careful, consistent delivery of this kind of drip is the only way...

mikehammerschmidt:

But dopa ALWAYS seems to be incompatible, and anyway, I figure it should always be changed to as large an access as possible due to it's potential for tissue extravasation if the peripheral IV

infiltrates! I didn't want to fool around with that line, and of course, since the patient had a previous episode of sustained

v-tach which resolved with a bolus of lido, I wasn't messing with

the lido drip either! I guess in retrospect, it was more prudent to

just endorse the med to the CCU, they were setting up to a-line

the patient anyway, so I'm sure a triple-lumen cath would be placed in him, then all meds could be administered safely.

Thanks for the input! :kiss

Ditto what Mark said!

Personally, I hate giving dopamine peripherally! In my unit, it's almost always given thru a central line of some sort. This pt sounds ideal for a triple lumen catheter to me or a picc line at least!

Mayhap if the patient is needing Lidocaine and Dopamine he is beyond the help of a single antibiotic. I did not read all of the replies but these two drugs are at odds with each other. But if the patinet is going to CCU and will most assuredly get a central line I would suggest antibiotic being held a while will not realy matter that greatly.

CCUNRS:

Exactly. I figured holding the antibiotic for a bit wouldn't compromise his care. I was about to take him to the CCU

where a central line would be placed anyway due to the

dopa administration. Anyway, this was at a teaching hospital,

and the antibiotic was part of a research study regarding

this antibiotic and pneumonia. Apparently he had some

infiltrates on CXR, plus he was in heart failure.

Thanks for the input.