IVPB question

It's almost harder to write it all down than it is to do it, but I'll try:

We get the IVPB, spike it to a primary line, flush the reseal, prime the line, hang the med, and let it run. When it finishes, we then take the line off the reseal, cap the line, and flush the reseal.

So you wind up with an empty bag of medication that is hanging on a capped, already-primed line. My hospital protocol says we can use that same line for three days, but since we're using the same exact med each time, it's a good thing that the line is primed with med and ready to go.

The next time you hang the med, you just spike the bag, flush the reseal, and hang it. No priming or backpriming is necessary. I've come to appreciate this technique because it keeps our volume-sensitive patients safer, and the reseals tend to hold up just as well either way, so there's really no justification for running a flush bag.

Hopefully that makes sense. Hopefully I'm reading the question right.

Thank you. This is what I am trying to understand...but excuse my ignorance and tell me what a reseal is... so you are saying the old med remains in the line and is used when the new bag is spiked? Even though it may be an every 8 or 12 hour med...it's ok in the tubing.

What was the thought behind this practice? To decrease the amount of fluid given?..because we're only talking about 30 mls or so of the flush...I can understand your fluid sensitive example but on the general med-surg floors you don't find this so much...

thanks for your help!

We hang separate tubing for each piggyback. The med stays into the tubing until the next dose.

What is a reseal?

Reseal = heplock

Ok what if they have a fluid, let's say NSS at 125. And you have to run levaquin as an IVPB. I spike the antibiotic the first time and prime the line. When I give another dose do I have to let what is in the line run out or can I simply start the antibiotic? I heard that what is in the tubing is comtamiated (sp?). Thanks Shannon

Not contaminated, but old. Why are we teaching backpriming to our students when it doesn't seem all that important if we're not doing it when hanging PB on a primary line. This just goes against my beliefs (it takes 20 ml to flush a primary line and if the patient never gets this, he is missing his entire dose. I am hearing that even though the hospital is having this as policy, a lot of nurses are not following it. I say you have to go with what you know as best practice.