IV piggyback

Generally it is best to have a medline ordered in order to flush the medication in. That is out in hospital protocol.

That's why locks were invented - so you didn't need a primary infusion. Just remember SASH - - Saline Antibiotic Saline Heparin

If we need to hang an antiobiotic and don't have an order for a primary infusion, we can write an order for normal saline to run as the primary per hospital policy. I would want a primary line to flush the antibiotic through when it was done infusing.

Primary infusions are not necessary. If they were, we would never get any meds given in the ER. Go with what the above poster advised. SASH- this is indeed why locks were invented.

If a patient has an order for an IV piggyback, but there is no current primary or order for one, is it okay to hang the piggyback solo (as a primary line)? As long as you disconnect the piggyback as soon as it is done infusing (not leaving the empty bag attached to the patient for an hour)? Is this considered poor practice?

It's not really a "piggyback" if there is no primary infusion. That's where the term "piggyback" comes from; you are piggybacking the secondary med in on the primary. If there is no primary infusion, just run the med in, then disconnect and flush when it's done. It's really not complicated.

SASH? why would you need heparin? It's a saline lock nowadays, no heparin required at all.

Yep,

do it all the time.

Except i don't do the Heparin, b/c mostly where i've worked, heparin has to be ordered separately, b/c its a drug and some people are allergic to it, or are on heparin/coumadin and it could mess with their PT/INR.

I give IV piggy's as primarys all the time, and then just flush with saline and go.

maggie

It's probably ordered as IVPB just in case there is a primary infusing. This way, whether there is a primary infusing or not, the pt will still get the meds. Just remember to flush before and after administration.

We get our antibiotics ordered IV. The only time a distinction is used on an IV product is to write IVP for some medications. Otherwise we use our nursing judgement ....primary line present? It's a piggyback. Saline lock? It's the primary and locked again following infusion.

SASH? why would you need heparin? It's a saline lock nowadays, no heparin required at all.

Oh my! You are right- I am showing my age!! Now it is just SAS- thanks for pointing that out.

We run IV antibiotics as primary on my floor all the time. Since I'm in a rehab facility, pt's having IVF running is an exception, not a rule. Most that get IV meds of any kind have a PICC and are on IV antibiotics for several weeks. We use SAS, just as the above posters have mentioned.

Thank you for your feedback, I greatly appreciate it!