IV help

[CherrySyrup BSN RN CPN, BSN, RN]

Hi all, I'm a new grad RN. I was hoping you could explain a few IV questions for me. 1) is the primary reason for piggy backing an IV so that whatever is being run in, say an abx, is flushed after? 2) if 2 meds are incompatible can they be given through different ports in the same IV site? Thanks!

[CherrySyrup BSN RN CPN, BSN, RN]

Hi all, I'm a brand new grad RN and need some help with IVs. I still get a little confused on the actual machines/tubing and how they work. For instance, putting two incompatible meds through different ports.

Does anyone know of any good online resources for IV therapy? Did your school to a good job of drilling it into your head? Mine seriously spent like 2 days on it.

[roser13, ASN, RN]

1) is a good reason for piggy-backing. However, most antibiotics are already diluted. Think about the convenience/efficiency factor if the patient has maintenance fluids running already. Instead of disconnecting the main line in order to infuse the antibiotic, keeping track of the time and getting back to the patient in time to reconnect the main line.....not so much fun. Plus, all the dis- and re-connecting opens the patient's line up to potential contamination.

2) If 2 meds are incompatible, they can be given at different times into the same IV site, provided that you use separate lines and flush in betwee.

[amoLucia]

I have some concerns that you're struggling so much so its early on in your position there. Do you have a preceptor/mentor that you can brainstorm with? An IV team person or even the pharmacy can give some information.

Also a facility IV Policy & Procedure Manual should be able to give you some information. I know I sound like a broken record about P&P Manuals (IV, Infection Control, MSDS, WOUNDS, etc) but they do reflect the protocols that should be maintained for your specific facility. There shouldn't be problems if you're following its info. But if you deviate from it, you're setting yourself up for mistakes and the wrath of the Powers That Be.

[iluvivt, BSN, RN]

Piggybacking is just one way to give a multitude of medications. It allows for the primary IVF to take over after the partial-fill,mini bag or piggyback or secondary whatever name you like is completed. Most pumps have built in safety features and functions to administer secondaries safely and with the prevention of the line backing up with blood and clotting off. It is imperative that the secondary is compatible with the primary IVF or other IV infusion you have infusing. Secondaries also allow the nurse to backflush and this minimizing opening the system.

You must check to make certain anything that mixes with any other IVF and IV medications are compatible. You have to become familiar with various types of VADs and tubings so you can determine the best way to administer the medication

For example, if you have a dual lumen PICC line you can administer IVF in one lumen and a medication that NOT compatible with your primary IVF on the other lumen simultaneously. This is b/c of the design of the PICC with the catheter having two entirely separate lumens. If you have a peripheral and have the same situation you may be able to administer them simultaneously if you have a double T ext at the site or a double extension set attached directly to the catheter. IF your secondary is NOT compatible with your primary IVFs you are going to need to administer ii a different way. You can start another PIV..you can hold your IVF (if you can) and administer the medication as a primary intermittent. being certain to flush with NSS before and after the medication...add a double t ext at the site (if you can ) It's kind of like plumbing and their are lots of ways to set it up but you must have a rational for what you are doing.

As a side note there are 3 types of incompatibilities ,physical.chemical, and therapeutic. My point here is that you will not necessarily see a precipitate in the tubing or have a precipitate plug your catheter should you have a chemical or therapeutic incompatibility but these will definitely effect the efficacy of the drug.

I can suggest a basic IV therapy book for you but you have to have your co-workers help you out here. If you have an IV team please spend at least one day with them.

[brillohead, ADN, RN]

i can suggest a basic iv therapy book for you but you have to have your co-workers help you out here. if you have an iv team please spend at least one day with them.

is there any particular book that you think is especially helpful? i'm a student nurse right now, but would really like to get a better grasp of all things iv-related before starting my med-surg iii class in the fall.

[beeker]

There is a good app for checking this, I forget what it is called. Anyone remember?

[iluvivt, BSN, RN]

As a novice I would start out with IV therapy made incredibly easy . Then I would advance to Sharon Weinstin's Intravenous Therapy Practice and Principles. I would also get the manual on any pump you may use. You can usually make a photocopy of it if the nursing unit has one. If not you can try on-line or call the 1 800 number of the company and they will either E mail you a copy or mail you one. They also have pocket guides they can send you. I will not use any Iv pump until I review the manual. kkkk

[minnymi]

2) if 2 meds are incompatible can they be given through different ports in the same IV site? Thanks!

no! incompatible meds can't be given through different ports in the same site. do you mean different lines?

maybe this is a difference in semantics, but one line can have several different ports. attaching an incompatible med to a different port in the line is most definitely pushing both the meds through the same line.