PCA pump

[luvmydogNC]

New nurse here and I have a question about PCA pumps. If I have a patient with one IV and PCA dilaudid is running through it (along with NS), can I push other meds through this PCA line? This could be a silly question. I did not have experience with PCA pumps in nursing school, but I thought I read somewhere or was told not to push meds through this line. Anyway, this triggered me to question what I was doing. I couldn't find any information on the subject when I tried to search on my own. Thank you!

[noelly10]

Definitely would not do that. That is a pretty big no no, I feel, to push other meds in the same line that the d is running (dilaudid). For one thing, you have to consider possible med interactions.

[Larry3373]

I'm not sure why this wouldn't be ok if the meds are compatible and you are pushing at a distal port near the patient to avoid bolusing the patient with too much pain med at once. When in doubt, just temporarily unhook the PCA and flush with NS first, push your med, and then restart the PCA. If the above criteria is met, there is no reason it would be unsafe, but the more important question is what, if anything, do your facility policies have to say on this question.

[noelly10]

I'm not sure why this wouldn't be ok if the meds are compatible and you are pushing at a distal port near the patient to avoid bolusing the patient with too much pain med at once. When in doubt, just temporarily unhook the PCA and flush with NS first, push your med, and then restart the PCA. If the above criteria is met, there is no reason it would be unsafe, but the more important question is what, if anything, do your facility policies have to say on this question.

I was actually going to say what are the hospitals policies regarding that after I posted. But you are right, you could unhook the PCA and flush with NS before administering another med. I stand corrected!

[Jory, MSN, APRN, CNM]

It depends...I would look to see when the last dose was delivered because a flush could bolus the patient.

[noelly10]

It depends...I would look to see when the last dose was delivered because a flush could bolus the patient.

Also true. Now I'm confused lol. I say, if the patient has another line you can use to administer meds, I would use that line. Let the PCA line be your last choice, but don't do it immediately. Check your hospital policy regarding that, and also you could consult with your charge nurse to see if he/she knows if using that line is okay.

[luvmydogNC]

Thanks for the replies. I wasn't sure what to do in the moment so I took the safe route and just temporarily unhooked the PCA, flushed NS, administered my push, and flushed before hooking the PCA back (like what Larry3373 said). The meds were compatible but I never thought about it giving the patient a bolus. Yikes! I couldn't find anything in the policies when I searched the database. I'll remember to ask my charge nurse next shift. Thanks.

[loriangel14, RN]

Do the PCAs you guys deal with run IV? Ours are always subcutaneous.

[RainMom]

As long as your meds are compatible (& there aren't that many that aren't compatible with dilaudid - cipro & valium would probably be the most common you'd run across), it's fine. How are your lines attached to the pt? The PCA is typically attached to a primary line, so unless the pt just gave themselves a dose or it has a continuous dose programmed, there likely won't be any dilaudid in the line anyway. Just push your drug through another port on the primary or as mentioned above, detach the PCA line & push your drug through; no need to flush unless incompatible with the dilaudid as your primary fluid will flush it through.

[RainMom]

cipro & valium

Ooops, should have been Ancef & valium.