Potassium IV hack

[atlnurse7]

I found a great hack for administering Potassium through a PIV! 

I had a DKA patient yesterday who was off her insulin drip and alert and oriented x 4. I tried to give her PO potassium but she declined and said she rather have IV instead. I warned her it would hurt, and she said okay anyways. I primed my line and threw a filter on it, and it didn’t burn or hurt her at all. Line was still patent with a good blood return and a flush about 20 min after the potassium had finished infusing. 

[offlabel]

write it up!

[MunoRN, RN]

Many patients experience no significant discomfort with a peripheral potassium infusion, if I'm wearing light blue scrubs when a patient has no pain with a K infusion, it would be questionable if I attributed that to wearing light blue scrubs.

[narsing]

I have never heard of filter being used. I usually Y tube it to fluids and just make sure they don't have CHF history. I will say tho that if they continue to refuse PO and have fluid order to try to add K to the fluids instead. We do it a lot of times for NPO patients 

[mfci]

This would seem to violate the "right route" - you are doing something with the aministration that wasn't ordered.  It may be harmless or it may not be, but I believe it is outside of our scope of practice.

I would advise that you confirm with the MD or pharmacist before you alter the administration of a medication.  Do you want to trust your license to your preceptor?

The more common practice that I've seen would be to slow down the rate.  But I let the doc know when I do that.

 

[Hoosier_RN, MSN]

I just asked the ICU nephrologist (here in dialysis clinic office early) if using a filter with IV potassium is a thing. He said no, it can actually filter out some of the potassium. Not a good thing if patient is hypokalemic. Just passing that on

[atlnurse7]

IDK how it would be wrong route, my hospitals critical care nephrologist thought it was brilliant and my patients redraw labs weren’t impacted negatively. It raised her potassium to within normal limits as to be expected. 
it would be wrong route if I was putting it to a peripheral and the order was for a central line. If it’s for a central line you should have a filter on it either way. So saying it filters out some of the potassium wouldn’t make much sense. 
putting a filter on the end of a peripheral is still given through an IV, and if that’s the ordered route, then you’re still administering correctly. 

[nurseinthemaking24, BSN, RN]

I’ve never seen a K+ order for a central line specify that an IV filter is needed. It’s standard policy at my facility that if it’s going through a central line, it needs a filter UNLESS it’s propofol. 

[Hoosier_RN, MSN]

19 hours ago, atlnurse7 said:

IDK how it would be wrong route, my hospitals critical care nephrologist thought it was brilliant and my patients redraw labs weren’t impacted negatively. It raised her potassium to within normal limits as to be expected. 
it would be wrong route if I was putting it to a peripheral and the order was for a central line. If it’s for a central line you should have a filter on it either way. So saying it filters out some of the potassium wouldn’t make much sense. 
putting a filter on the end of a peripheral is still given through an IV, and if that’s the ordered route, then you’re still administering correctly. 

I guess different docs see things differently. Not gonna argue it, as I work dialysis and am usually taking potassium off

[offlabel]

On 6/22/2022 at 2:42 AM, Hoosier_RN said:

I just asked the ICU nephrologist (here in dialysis clinic office early) if using a filter with IV potassium is a thing. He said no, it can actually filter out some of the potassium. Not a good thing if patient is hypokalemic. Just passing that on

An absurd claim. Air filters are just IV extensions that are used widely for all kinds of medication infusions in patients every single day. 

[Hoosier_RN, MSN]

11 hours ago, offlabel said:

An absurd claim. Air filters are just IV extensions that are used widely for all kinds of medication infusions in patients every single day. 

I'll tell him you said so.

Filters remove various sizes of particulate matter, depending on the grade of filter (generally measured in microns). An extension isn't usually a filter, its extension tubing. 2 totally different things

[Tegridy]

N=1

[Delia37, MSN]

I would be weary of this "hack" as it is not standard practice. I agree with Hoosier in regard to having some  caution in using a filter in a medication that does not require it (personally, never heard of this). Sound like you are on orientation; it is the Wild West out there, please make sure your practice follows hospital protocol.