Starting a second IV piggyback

[girlinred]

So say a patient is receiving IV meds, their primary is already set up and running. You hang a Piggyback antibiotic at 0900 and after its finished you are ordered to hang a different antibiotic piggyback at 1200. The tubing for the 0900 piggyback wont expire until the next day. So when starting the new antibiotic you have to use new tubing since its a different drug right?

Also, would you leave the finished antibiotic bag hanging (but disconnected) so that you could use that tubing the next time they need that same medication?

And what would be some side effects of using the same tubing for different medications?

[Esme12, ASN, BSN, RN]

This depends on your facility policy. If they are compatible you can just hang the next bag. Check your facility policy

[MunoRN, RN]

Why are you thinking you would need to use a new secondary tubing for a different antibiotic? Why would you need to use a different secondary tubing but not a different primary tubing?

[TeeKay12]

You're hanging a primary maintenance fluid and then some secondary lines with antibiotics Y'd into it?

Yes, you need to run a new secondary line for each and every new pb. Make sure the maintenance fluids are compatible first! (I know that seems like a silly thing, but really, so many nurses forget to check on the second secondary line!)

You can usually save the line, capping it first, for the next infusion of that same drug. Check your hospital policy.

[NightOwl0624]

Well, our policy is different. I was taught it is better to keep a closed system than to use new tubing for every new secondary. So, assuming the secondary is compatible with the primary solution, you would simply back prime the secondary line (as in, hold the senondary bag below the primary bag so the primary solution backs up into the empty bag), then change the secondary bag to the new bag and continue as usual. It is one of my huge pet peeves when nurses hang each antibiotic with its own line when it isn't necessary.

but that's our policy. Best to check yours and do it the way they want you to!

[dah doh, BSN, RN]

Follow your facility's policy!

At my facility, we used to change the secondary line with each different antibiotic as long as the antibiotic was compatible with the main IV fluid.

However, we now try to maintain a "closed" system so we don't change the secondary line with each antibiotic. We will back prime the same secondary tubing with the main IV fluid and just change out the antibiotic bag after a compatibility check.