Y-porting potassium IV - what's your policy?

[sarmrn]

At my hospital we do not have a policy for y-tubing peripheral IV potassium. Myself and couple of other nurses are trying to find evidence based research to submit to the powers-that-be so that we can get a written policy. As a new RN, I was given instruction by more experienced RNs that when hanging IV potassium to a peripheral IV that the best thing to do to prevent extravasation/burning is to get 2 pumps, hang the potassium on 1 pump and y-port it to NS which is hung using its own pump. However, I cannot find any research/articles on doing this. The closest I can find is that many articles say "be careful/aware of extravasation and take measures to avoid it" but do not say what those "measures" should be. I have even had our hospital librarian search for articles and he didn't find anything pertinent.

So my question is: what is your personal policy as an RN when you hang potassium AND does your facility have a written policy for y-porting or diluting potassium in some way? I'm hoping that maybe if I can at least get an RN consensus that I can present that and get a written policy to help out our new RNs (and more experience RNs too!) AND prevent harm to our patients.

Thanks in advance for any help/suggestions/comments!

[Guest957596]

Our potassium only comes as 20mEq/100ccNS. We don't have any 500cc bags with potassium. Sometimes we do as you suggested, and run some saline concurrently, but sometimes we add lidocaine to the potassium bag.

Adding lidocaine? Hmmm? That sounds interesting!

[runsonsyrup]

When I worked in the ED, we hung the potassium on a pump at the ordered rate, and then gravity-hung NS piggyback, titrating the rate to patient's comfort, within reason and keeping fluid overload issues in mind. I've never seen an ordered rate for the piggyback. Some patients can tolerate less NS, others are really bothered by the burning sensation.

Adding lidocaine or bicarb does sound interesting!