Manifold..safe to mix or not.

Nurses General Nursing

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Specializes in Telemetry, SICU/MICU/CTICU, Detainee med.

I have been pondering this for sometime now. I have had some nurses tell me, that medication you cannot normally mix, are safe to run through a manifold together. I have always seperated them. What is the truth? Does anyone have any documentation or a text reference?? Thanks.

What's a manifold?

Specializes in Pulmonary, MICU.

Yes. And no. But more or less yes. Realistically, medications that are incompatible will be exposed to each other within a manifold. I think the theory that makes us feel that it is "safe" is that the exposure time and quantity of exposure are greatly limited. As such the ability to form precipitates or inactivate is also greatly reduced. I don't have any literature on it, but that's the theory.

A manifold is a luer-locking device that effectively turns a single port (usually of a central line) into 4 ports with the ability to turn each port on and off independently. Used for patients who are getting tons of drips but don't have the access for them. There is a common sentiment that when using a manifold you can run y-site incompatible drugs together because of the logic listed above. A manifold kind looks like this (ignore the underscores, they are just used for formatting):

____Port__Port__Port

_____||____||____||

Port==============Connection to IV

Specializes in Nursing Home ,Dementia Care,Neurology..

I know that in UK the BNF (British National Formulary) lists drugs that should not be mixed together because they cause 'clumping ' and can cause blockages.I would imagine that you have the same info in the US re these drugs.

Specializes in PICU/NICU.

You can usually run meds together on a manifold that are "y- site " compatible.... they might not be able to mix in a syringe together but will be ok for a short time in a manifold.

Specializes in Telemetry, SICU/MICU/CTICU, Detainee med.
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