Piggyback IV question

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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.

Specializes in Cardiac.

Goodness - I just finished a Preceptorship (for school) in a TICU, & when I read these boards I feel like everything I learned from my preceptor is Kaa Kaa!!

So quickly: I was running MIV NS, and q3 IVPB Pipercillan for 30mins and then Vanco for 120mins. He told me that I did not have to change the line - and mentioned nothing about back-flushing (not sure what that is), and we would leave them hang empty until the next dose arrived.... He told me that nearly ALL abx are compatible??

Is this right? BTW, this was through the distal port on a PICC, and the pt. had Heparin running through the primary port.

Please don't bash me - this was my first "real" all hands-on rotation, and I'm running out to buy an IV pocket guide asap!

Thanks for your help!!!

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Specializes in Medical/Surgical.
hang all your piggybacks thru a NS main line....you back flush with the saline and use one tubing for all abt....

:yeahthat:

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Specializes in Medical/Surgical.
Goodness - I just finished a Preceptorship (for school) in a TICU, & when I read these boards I feel like everything I learned from my preceptor is Kaa Kaa!!

So quickly: I was running MIV NS, and q3 IVPB Pipercillan for 30mins and then Vanco for 120mins. He told me that I did not have to change the line - and mentioned nothing about back-flushing (not sure what that is), and we would leave them hang empty until the next dose arrived.... He told me that nearly ALL abx are compatible??

Is this right? BTW, this was through the distal port on a PICC, and the pt. had Heparin running through the primary port.

Please don't bash me - this was my first "real" all hands-on rotation, and I'm running out to buy an IV pocket guide asap!

Thanks for your help!!!

No. Not all antibiotics are compatible. Infact, most manufacturers recommend that you hang EVERYTHING (all antibiotics) completely seperately. Zosyn (piperacillin) and Vanc are compatible. You are safe there. But don't just assume. Your Pocket guide will come in handy until you get familiar. Mine still hangs around in my locker incase i run up an a med I'm not familiar with!!

BTW, backflushing is just taking the piggyback bag down (still attached) and holding it for a moment below the level of the primary bag. The piggyback tube and drip chamber will fill with the primary fluid.

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Specializes in Cardiac.

Thanks for responding so quickly Jlmb!!! Happy to hear I didn't make any HUGE mistakes by "assuming"! It's just so tough to apply what you know is right all the time when it seems like what you "should do" and "what you do, do" are miles apart when you're on the floor!

When I would ask specific questions about "why", or "how do you know for sure", I would get the same response from many of the TICU staff which was "well, because that's the way I've always done it".....

It seems like it would be nearly impossible to complete all tasks and have time to research everything that I don't know....

Well, I know that I obviously will need some years of exp to work on a floor like that, but I'm really ashamed of myself looking back now bc I took his word for everything - and I know better!! What was I thinking not referencing these meds just bc he told me how he does it. It's not his failure it's mine - I know that he has some knowledge behind his practices, I was just doing what I was told blindly!

Whew, I'm venting - sorry, I guess after the 120hrs of 7p shifts I'm just now realizing what happened lol!

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I always say when in doubt get a 2nd tubing set...then you know your ok.. provided your primary and secondary are compatible of course :p

In my facility potassium cannoot be hung with anything else as its a guardrails drug. No piggy backs allowed... UNLESS its the standard D51/2NS with K for post surgical pts.

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Specializes in Cardiac.
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.

Well, this last post of mine was in 2007. Our policy has changed and with it so has my practice.

For us, we use a dedicated line for each Abx, and they get changed out q24hrs. So basically, I enter the room with a handful of secondary tubings and start fresh each shift.

I feel better about this. New fresh lines for the pt. I actually cringe at the whole backflushing thing that I always did previously.

I'm sure the policy will change again though!

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