Quote from dudette10
i can't wrap my mind around this if you're using only one channel. How do you get the primary (the bag that's lower) to drip while the piggyback is running?
Sorry if I am hijacking your question to the quoted poster but since I answered pretty much the same thing, I think I can clarify. We use the Abbott Plum X pump (picture here: http://www.isismedical.net/Infusi1.jpg
) and it can run two things concurrently, one being on the "A" (primary) line and one being on the "B" (typically "piggyback") line. You program the "A" side and press START. Then you attach the second IV using secondary tubing to the port on the cartridge (after flushing the line) and run it on the "B" line. The pump allows the user to select "Concurrent" instead of "Piggyback" as the MODE and when you press START, both will run at the same time instead of B running as a piggyback.
We use it mainly for TPN with lipids. We run the TPN on the primary tubing with the lipids on the secondary tubing running in "CONCURRENT" mode instead of "PIGGYBACK" mode so you only need one pump and only one IV port to plug the line into. We also use CONCURRENT a lot when a patient is on Ocreotide or a continuous antibiotic gtt and they also have IVF. The IVF run on the "A" line and the Ocreotide or ABX run on the "B" line in Concurrent mode. I love it. I've never used pumps that can do this until working at the hospital I work at now.
There is no need for the primary bag to be higher than the secondary bag. In fact, we always throw away the hanger that comes in the bag with the secondary tubing.
As I said in my original response, I have never seen an order like the original poster is asking about. I have never had to program a concurrent IV for more than 50cc/hr so I am not sure if there is an upper limit on the rate if the Concurrent IV. If I were to try to program it as a Concurrent and the rate was too high, I'd grab a second pump and Y-site it or use a pigtail.