No more piggybacking zosyn?

[RENEfromLA]

A new policy at our hospital states that we cannot piggyback zosyn ...this may be a dumb question (I am a brand new nurse so bear with me) but WHY NOT? WHY CAN'T WE? Please let me hear your reason. THANK YOU ALL!

[That Guy, BSN, RN, EMT-B]

Zoysn is supposed to be run over a four hour period. This is a new policy since most people used to run it as a rapid infusion 15-30mins. If your running it over 4 hours twice a day, what ever fluid is on the primary line would now be paused for a total of at least 8 hours a day.

Thats why you can run fluids concurrently. Eliminating that problem.

[StarryEyed, RN]

We run Zosyn on a microinfuser, not as a piggyback. I think ER does run it as piggyback. The microinfuser tubing is very thin so I doubt much gets wasted whether it's run as a primary or on a Y-port. And like other's I never heard of it being run over 4 hours. I have pt's that i have to give tons of abx and 4 hrs wouldn't allow for everything to be given, especially if they're also on electrolyte protocols!

[VICEDRN, BSN, RN]

what esme said...

[Do-over, ASN, RN]

We are running it over hours mostly. I run it as a piggyback, but yes, that would lower any maintenance fluids being received. If I was concerned about that, I would run a flush bag into the primary fluid line and piggyback the Zosyn on the flush bag.

PS - If there are so many ABX or whatever, that need to be run (blood products, lytes replacement, etc) I'll start another line if possible.

[psu_213, BSN, RN]

When running over 4 hrs, I can see why they do not want you to piggyback it (having the primary fluids not running for 4 hours at a time while the Zosyn in running). However, you could always piggyback it into KVO fluids, Y site this into the primary fluids, which would run through the entire infusion.

On a side note, in our ER we can still run Zosyn over 30 minutes (it is 4 hours on the floor). Policy is that we supposed to piggyback it, but many nurses run it as a primary.

[nerdtonurse?, BSN, RN]

Interesting. Like a 80mg protonix drip as opposed to 40 mg ivp BID. Wonder if they'll end up creating special "drip" protocols where I work....

[sethmctenn]

We typically run a loading dose of 2.25gm then a continuous infusion at 8.3cc/hr after the loading dose.

[CandaceHinz]

Our hospital also went to 4 hour infusion time every 6-8 hours on for 4 off 2 hrs or on 4 off 4hrs, it is renal dosing. best practice medication is more effective and easier on the kidneys. we connect it to a maintence fluid at the Y site under the pump because the infusion only runs at 12.5ml/hr. also in the ER and the first dose can be given over 30min considered a loading dose, then all other doses run at extended infusion.