Piggyback IV question

[big apple]

Say a primary line is running potassium chloride and you piggyback it with vanco, after the vanco is done, another piggyback of cipro needs to go up. My question is, do you change the secondary tubing to avoid cipro and vanco incompatibility?

Thanks.

[woody62, RN]

Say a primary line is running potassium chloride and you piggyback it with vanco, after the vanco is done, another piggyback of cipro needs to go up. My question is, do you change the secondary tubing to avoid cipro and vanco incompatibility?

Thanks.

I would change both the primary and secondary tubing. No mater if the primary tubing has potassium running, it still had the vanco running thru it.

Woody:balloons:

[FireStarterRN, BSN, RN]

Yes, I would put different tubing on each antibiotic.

[deeDawntee, RN]

Yes, definitely get new tubing, you can cap off the vanco tubing and reuse it (make sure it is dated, etc) they make special IV caps for that purpose, at least they do at my facility.

[bill4745, RN]

ALways.

[morte, LPN, LVN]

strictly speaking, yes. but this would be one reason to hang all your piggybacks thru a NS main line....you back flush with the saline and use one tubing for all abt....

[MoopleRN]

That works... if your primary IS normal saline. If the primary is not NS, as in the case the original post says, I would check compatibility with ANY/ALL piggys. At my facility, each piggy has its own tubing (dated) even if we're just running NS.

ALWAYS check compatibility.

ALWAYS check with the pharmacy when in doubt.

If in doubt about something, DON'T.

[Ariesbsn]

I get what morte means. Having a designated antibiotic line of just NS and then you can piggyback all your antibiotics after you back flush.

The unfortunate thing about that is actually getting the piggyback in. We use Alaris pumps and it can take a lot longer than you would think it should to get the piggy backs in. Even after they ruled out user error (forgetting to unclamp the secondary tubing) it was still such a problem that policy changed and certain things like Vanc and KCL needed to be run in as a primary.

[GrnHonu99, RN]

Say a primary line is running potassium chloride and you piggyback it with vanco, after the vanco is done, another piggyback of cipro needs to go up. My question is, do you change the secondary tubing to avoid cipro and vanco incompatibility?

Thanks.

All new IVPB meds need their own PB tubing..I will spike a vanco bag and that bag has tubing all its own. If I hang cefapime, the cef gets its own line...if i go to hang another bag of vanco, i will just replace the first, old, used vanco bag with the new one...if im not using the pB then i cap the end and keep it on my pole..the tubing gets changed q72hrs. Some things just don't mix.

[cardiacRN2006, ADN, RN]

strictly speaking, yes. but this would be one reason to hang all your piggybacks thru a NS main line....you back flush with the saline and use one tubing for all abt....

That's what I do as well. We don't have tubing for each Abx! What a mess!

I always have a dedicated NS line for Abx. If all my ports are full, then I'll just start a new IV for such an occasion. I back flush when I change over the IVPB bags.

[GrnHonu99, RN]

Clarification: Work in the ICU so 99% of the time the pt. always has MIVF going. I just PB into that with each ABX having their own secondary tubing. When i'm done with my vanc, i d/c from MIVF, caap it and start another...give some time usually to flush the MIVF line before starting another ABX

[big apple]

I would change both the primary and secondary tubing. No mater if the primary tubing has potassium running, it still had the vanco running thru it.

Woody:balloons:

What are the chances of the vanco still remaining in the primary line if you dont change the primary tubing, but only change the secondary for the new antbx?