Needed More Clarification on Piggyback.

[DJ Trance AZ, BSN, RN]

hey guys, i needed some clarifications re: piggyback. i have checked with my nx. books but none of them give me good definition. so here are my qs:

1). what is piggyback and what is its purpose?

2). does it always needed to be hung higher (if without an iv pump) and therefore, flow faster?

thanks so much!

.eric

[tencat]

Hi! A piggyback is a bag of medication mixed with fluids (like normal saline) that you hook into an already running primary IV. Antibiotics/antifungals are really common medications that are run as piggybacks.

The piggyback is hung higher than the primary bag because (anyone correct me if I'm wrong, this is just my understanding) gravity will pull the fluid from the higher bag first, then when that's out it will resume pulling fluids from the primary bag.

Hope that helps.

[CritterLover, BSN, RN]

agree with above.

wanted to add that piggy-backs are usually for intermittent infusion (abx, h2 blockers, etc).

[DJ Trance AZ, BSN, RN]

First of all, thanks for the clarifications.

Now, is it always the case that the piggyback is to be infused first, over the primary infusion (say D5W)?

.ERiC

[ginger58, ASN, RN]

First of all, thanks for the clarifications.

Now, is it always the case that the piggyback is to be infused first, over the primary infusion (say D5W)?

.ERiC

I don't totally understand your question. The primary infusion would most likely already to infusing, then at the stated time the PB would be hung higher than the primary and would be programed to run by itself, and when it is done the primary may start infusing again. If a pt. only has an IV for PB infusion then we hang NS and PB, let's say an antibiotic into the NS line and run the antibiotic at the scheduled time, flush the line at the end of the infusion and then disconnect the IV from the pt.

[all4schwa]

it's a piggyback because you are using the same line that their fluids are already infusing into, borrowing the line. yes, that's why you hang it higher, but an infusion pump will pull from wherever it's supposed to. (some pumps) also, you can set it up to either, run the piggyback and then automatically flip back to the primary fluids, or you can set them two run two fluids together. usually you would set it to run the piggyback and then flip back to primary, but if it's something like a piggyback of potassium (often called k-riders) you may want to run that concurrently.

[JentheRN05, RN]

As far as your second question - no you give the antibiotic as ordered, usually patients will be on a pump - if thats the case - up to the point that the atx are ordered they will get their regular IV fluid (whether that be D5 or NS or whatever), when the antibiotic is ordered you will stop the normal infusion and start the antibiotic (always above the regular fluid) usually there is a hook like thingy that you hang the regular fluid on so that it's lower than the antibiotic. Then, once antibiotic is done you start up regular fluid, UNLESS there's an order for them to run concurrantly, then you hook up both lines to the IV pump each in seperate tubing and they run in at the same at the regular/antibiotic. BUt you have to set the pump to do that.

[DJ Trance AZ, BSN, RN]

I had more chance to work on IV and IV meds this week. I think I do get the idea of a piggyback or a secondary infusion (on the same IV line)...I am feeling more comfortable now when working with IVs, heh.

.Eric