IV extensions

Okami_CCRN, BSN, RN · May 24, 2017

When you have one peripheral IV with an extension set and you must add other medications that are compatible with one another you would connect them at the Y-site of the IV tubing closest to the hub. For example lets suppose you had a patient who was intubated and needed sedation/analgesia, you would hang a KVO straight to the extension tubing, then you would hang your fentanyl drip to the Y Site closest to the hub of the KVO line, and then you would hang your propofol to the Y-site of the fentanyl primary tubing closest to its hub. I hope that makes sense.

Dubs3035 · May 25, 2017

That does make sense. But would it also be ok to put a double lumen extension on so I have a free port to push other meds? Does it matter where you add a double or triple lumen? Can you add it to IV hub, single extension or y site on primary tubing?

Okami_CCRN, BSN, RN · May 25, 2017

Where I work we do not use double/triple lumen extension sets for peripheral IV's, but doing a quick search I see that such products are available, in that case you would prime each lumen with NS and attach it directly to the IV hub, and then connect the primary tubing to the extension set.

If you wish, you could give IV push medication through the free port, but remember if you are giving something IV push through that port it must be compatible with whatever is infusing as it is going into ONE lumen; unless you pause the running medication, flush, give med, and flush again.

It would also be in your best interest to look up your policy and procedure for inserting and maintaining peripheral IV access.

Atl-Murse · May 25, 2017

Simple answer is yes. You can attach a Y extension to the an existing set to make 2 ports

EllaBella1, BSN · May 25, 2017

I guess you could, but I would be wary of putting so many meds through one peripheral IV together. If you really need that many ports I would start a second IV.

Dubs3035 · May 25, 2017

It's not that many. Mainline LR, mag, pit, & free port for pain meds.

MunoRN, RN · May 25, 2017

I guess you could, but I would be wary of putting so many meds through one peripheral IV together. If you really need that many ports I would start a second IV.

Why would you start a second IV?

MunoRN, RN · May 25, 2017

These extensions are sometimes "daisy chained" together to provide the number of ports needed, open hearts typically come back with 5 or 6 triple spliters daisy chained together.

Here.I.Stand, BSN, RN · May 25, 2017

we sometimes use those mini-bifuse sets, but remember the line itself is still a single lumen. Where you can run incompatible meds through two ports on a PICC or central line, you can only run compatible meds through a mini-bifuse. Also, if you're flushing one port for IVP meds, keep in mind you're flushing whatever other med along with it. I mean it's a tiny volume so that may not do anything clinically significant, but if it's a vasoactive med or something like Propofol that can drop BP, you need to be careful about bolusing someone

Dubs3035 · May 25, 2017

Can you explain " daisy chained". Sounds perfect.

MunoRN, RN · May 25, 2017

Can you explain " daisy chained". Sounds perfect.

You attach a splitter to one of the ports of another splitter, then attach another splitter to one of the ports of the splitter you attached to the first one, and on and on.