IV question

sapphire18 · Jun 30, 2012

Why wouldn't you just use secondary tubing?

Animal3 · Jun 30, 2012

Sometimes they come from pacu like this or another nurse sets it up... I always use secondary I was just curious if it works the same?

KelRN215, BSN, RN · Jun 30, 2012

On any of the pumps I've ever used, you couldn't because the primary tubing has the cartridge that has to fit into the pump. The secondary line doesn't have a cartridge and just gets connected to the "B" port of the primary line. Theoretically, you could do it if you had 2 pumps and you could connect the secondary to the Y site of the primary but that seems like an awful lot of hassle when there's a much easier way to do it.

Animal3 · Jun 30, 2012

Sorry guess I didn't explain it correctly there is a primary line and the one to piggy back is on is a primary line set as well they connect primary to primary basically at the correct place

canned_bread · Jul 1, 2012

Are you talking about a Y connector? Because I never run 2 things through the same line... compatibility of drugs and stuff. If I am pushing a drug I might use the Y connector but you have to be careful of flushing... I'm a bit confused, maybe by your grammar and words?

iluvivt, BSN, RN · Jul 1, 2012

Think of it this way...above the level of the pump..secondary tubing should be used. If you want to access the system at a Y site that is below the level of the pump you need to use primary tubing. If you have any locked VAD and do not have any IVF running..you use a primary tubing...but b/c it is a primary intermittent....the intermittent tubing policies apply(whatever yours happen to be). INS recommends q24 hrs tubing change on primary intermittent or secondaries that function in that manner due to the frequent connections and disconnections . CDC makes no recommendation

SCnurse2010 · Jul 1, 2012

The way I understood the OP, a primary tubing was connected at the normal secondary port above the pump. I guess if all the clamps were open, it could work...lots of backpriming for the next dose though! If I didn't have any secondary tubing and the patient had regular IVF, I would add another module and hook the second primary at the Y site (as long as they were compatible).

aging1 · Jul 1, 2012

Sure you can, as long as the tubing isn't automatically "clamped" unless it's in a pump. It's just longer, but works the same way. You'd just want to infuse what's in the tubing at the end, as it might hold a significant percentage of the volume of a 50ml bag, f'rinstance.

A lot depends on the mechanics of the tubing/pump system. I've sometimes used a separate pump on the piggyback with primary tubing, if there's not a way to control the speed of infusion for a secondary med on the pump. Confused yet?

MunoRN, RN · Jul 2, 2012

If primary tubing is all you have available then yes, technically it will work. The length of the tubing does not affect the pressure at the connection point, in fact you could attach enough tubing to have it hang out the window and go down to the parking lot and back up and it would still work the same. One concern would be that you would have ports that might be confused for ports on a primary, not a secondary.

iluvivt, BSN, RN · Jul 2, 2012

The only good reason I can think of setting it up that way is b/c you ran out of secondary tubing. Yes...you will lose some of the medication in the extra tubing as well,which may or may not be significant based on concentration..dosage range and other factors.

MunoRN, RN · Jul 2, 2012

Think of it this way...above the level of the pump..secondary tubing should be used. If you want to access the system at a Y site that is below the level of the pump you need to use primary tubing. If you have any locked VAD and do not have any IVF running..you use a primary tubing...but b/c it is a primary intermittent....the intermittent tubing policies apply(whatever yours happen to be). INS recommends q24 hrs tubing change on primary intermittent or secondaries that function in that manner due to the frequent connections and disconnections . CDC makes no recommendation

This INS recommendation has always bothered me since it only encourages bad practice. Aside from the ridiculous terminology such as "continuous secondary" which doesn't even exist, the recommendation is often read that secondary tubing should be changed every 24 hours, which it should not. A secondary should remain attached to the primary set and therefore be changed with the primary set no more often than eery 72 hours, which leaves no reason to designate a separate time frame for secondaries other than to confuse people.