IV Y-site question

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Hello,

I've been in my final quarter internship in the ICU and it's been a blast, but there's one thing that's been bugging me. Let me give you a scenario...

The patient has a triple lumen CVC -- 1 port has Diprivan running, 1 port has Levophed running, 1 port is open for anything. We use Alaris pumps at the facility.

I have to give two antibiotics and for this scenario let's say they are compatible. Antibiotic A needs to run at 100 mL/hr while antibiotic B runs at 150 mL/hr. I set up two separate Alaris pumps with the corresponding rates. Would it be possible for me to run both antibiotics in that last port using the Y-site? If so, wouldn't that mean that antibiotic A is getting to the patient at a faster rate than it should be? Also there's the question of which line is actually hooked up to the CVC and which line is Y-site'd to the "primary" line.

It may not be much of an issue if we're dealing with antibiotics only, but what if it was an antibiotic and an electrolyte. What if I needed to give magnesium sulfate (instead of antibiotic A) which usually runs at a much slower rate?

Sorry if that is confusing. It might be better practice to just start a PIV and run the second antibiotic there.

Thanks!

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Specializes in Vascular Access.

My question to you is: Why are you wanting to run them at the same time anyway? Can't you run one over 30-60 minutes, flush with saline or D5W (If the IVAB isn't compatible with NS) and then hang the second IVAB? I would always be concerned that if I ran two at the same time, and my patient had a reaction, which one is the problematic drug?

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That definitely sounds like the safer option/better practice. Thanks!

I guess what I'm trying to get at in a more general way is if I have two compatible medications attached to their own separate IV pumps and Y-site them, the medication will get to the patient at a rate that's the fastest.

My other train of though is since both meds are being controlled by their own IV pump, wouldn't the med that's running at a slower rate not be affected by the med going at a faster rate?

I'm really lost with this concept. Thanks!

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Specializes in Critical Care.

No. Since they're on different pumps, it wouldn't go any faster. Say for example you have 99 units of insulin in 99 mL of NS or 1u / mL. If you're giving insulin at 2 units / hr (or 2 mL / hr), regardless of what's y-ed in, the pump is only pushing out 2 units of insulin per hour.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
That definitely sounds like the safer option/better practice. Thanks!

I guess what I'm trying to get at in a more general way is if I have two compatible medications attached to their own separate IV pumps and Y-site them, the medication will get to the patient at a rate that's the fastest.

My other train of though is since both meds are being controlled by their own IV pump, wouldn't the med that's running at a slower rate not be affected by the med going at a faster rate?

I'm really lost with this concept. Thanks!

Don't over think it. Each one is being infused at it's own rate.

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