Potassium piggybacks

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I would like to know of any tricks to alleviate burning while adminstering Potassium IVPB. Right now I am running NS{faster rate} and the K+{slower rate} together using two primary IV lines with the K+ connected to the y port closest to the patient. Are there any more tips for alleviating the burning? This is frustrating to me because it takes sometimes an entire shift for a 100cc bag to infuse because the pt is complaining of burning.

I think it depends on the patient, but I have had good results w/ the warm packs and elevating the extremety when there has been an infiltration. :)

Just another tip for all, whether ice or heat...a doctor's order is required. Please let's all start making the physician accountable. We take on too much responsibility and then when the patient returns, we are the ones holding the "blame". Remember incident reports and physician orders can save us from court. Upon the studies I have seen, if there is "heat" coming from the body, the counter is "cold". Heat actually increases damage and allows bacteria to flow even more rapidly. This causes even more tissue damage. Sometimes what you see on the outside when you think it is healed, is not what is going on in the inside. Staph. is the greatest problem in the hospital and can grow in the tissues and blood without being seen on the outside. Again remember these patients don't always notice until weeks later. Peace and love...nothing less! Cathy

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I would like to know of any tricks to alleviate burning while adminstering Potassium IVPB. Right now I am running NS{faster rate} and the K+{slower rate} together using two primary IV lines with the K+ connected to the y port closest to the patient. Are there any more tips for alleviating the burning? This is frustrating to me because it takes sometimes an entire shift for a 100cc bag to infuse because the pt is complaining of burning.

I have written other responses on this message, but here is a bit of info that might be helpful. All must realize the seriousness of these type of vesicants. Pain is a sign. http://nsweb.nursingspectrum.com/ce/ce94.htm

Peace and love...nothing less! Cathy

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Cathy, thanks for the link. Good info.

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Specializes in Step down, ICU, ER, PACU, Amb. Surg.

Our facility has 100 ml bags with either 20 or 40 mEqs of K+ in them. I never heard of using lidocaine or Na+ HCO3 to neutralize or relieve the pain. I personally would be very uncomfortable masking potential warning signs of a nasty and damaging infiltrate. I do know that a K+ rider is not recommended to go through a vein smaller than the AC because of the potent damage that vesicants can cause. We try to get the K+ riders in within an hour but slow them based on the pt response and if all else fails, either get a central line in or in the ED, give them oral suppelments.

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Usually we hang a 250cc bag of NS with 40mEq of KCL with 100mg of lidocaine. Works like a charm most of the time. Our standard order for

_____mEq KCL ryder IVPB over 3-4 hrs.

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Our facility has 100 ml bags with either 20 or 40 mEqs of K+ in them. I never heard of using lidocaine or Na+ HCO3 to neutralize or relieve the pain. I personally would be very uncomfortable masking potential warning signs of a nasty and damaging infiltrate. I do know that a K+ rider is not recommended to go through a vein smaller than the AC because of the potent damage that vesicants can cause. We try to get the K+ riders in within an hour but slow them based on the pt response and if all else fails, either get a central line in or in the ED, give them oral suppelments.

I read an article stating just what you said, the use of lidocaine masks signs of potential problems,i.e, pain

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Specializes in oncology, surgical stepdown, ACLS & OCN.
Our facility has 100 ml bags with either 20 or 40 mEqs of K+ in them. I never heard of using lidocaine or Na+ HCO3 to neutralize or relieve the pain. I personally would be very uncomfortable masking potential warning signs of a nasty and damaging infiltrate. I do know that a K+ rider is not recommended to go through a vein smaller than the AC because of the potent damage that vesicants can cause. We try to get the K+ riders in within an hour but slow them based on the pt response and if all else fails, either get a central line in or in the ED, give them oral suppelments.

Our hospital does the same as yours, and I never heard of mixing lidocaine or anything else to mask the pain of infusing K+ ryders, I wouldn't feel comfortable w/ that either. We do use other sites on the arm or hand and infuse a 100cc bag w/ 20 or 40 meq"s of K+ over 4 hours. If there is any burning , pain or irritation we slow it down and it usually stops the pain, etc.

If it doesn't stop, we d/c the line and start a new one. :)

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Specializes in oncology, surgical stepdown, ACLS & OCN.
Our facility has 100 ml bags with either 20 or 40 mEqs of K+ in them. I never heard of using lidocaine or Na+ HCO3 to neutralize or relieve the pain. I personally would be very uncomfortable masking potential warning signs of a nasty and damaging infiltrate. I do know that a K+ rider is not recommended to go through a vein smaller than the AC because of the potent damage that vesicants can cause. We try to get the K+ riders in within an hour but slow them based on the pt response and if all else fails, either get a central line in or in the ED, give them oral suppelments.

Our hospital does the same as yours, and I never heard of mixing lidocaine or anything else to mask the pain of infusing K+ ryders, I wouldn't feel comfortable w/ that either. We do use other sites on the arm or hand and infuse a 100cc bag w/ 20 or 40 meq"s of K+ over 4 hours. If there is any burning , pain or irritation we slow it down and it usually stops the pain, etc.

If it doesn't stop, we d/c the line and start a new one. :)

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I would like to know of any tricks to alleviate burning while adminstering Potassium IVPB. Right now I am running NS{faster rate} and the K+{slower rate} together using two primary IV lines with the K+ connected to the y port closest to the patient. Are there any more tips for alleviating the burning? This is frustrating to me because it takes sometimes an entire shift for a 100cc bag to infuse because the pt is complaining of burning.

What I have done in the past as someone else mentioned, is I have further diluted the KCl with about 50cc NS. If slowing the rate alone does not work, then I add the NS and that does the trick. Good luck!

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I would like to know of any tricks to alleviate burning while adminstering Potassium IVPB. Right now I am running NS{faster rate} and the K+{slower rate} together using two primary IV lines with the K+ connected to the y port closest to the patient. Are there any more tips for alleviating the burning? This is frustrating to me because it takes sometimes an entire shift for a 100cc bag to infuse because the pt is complaining of burning.

What I have done in the past as someone else mentioned, is I have further diluted the KCl with about 50cc NS. If slowing the rate alone does not work, then I add the NS and that does the trick. Good luck!

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Specializes in oncology, surgical stepdown, ACLS & OCN.
What I have done in the past as someone else mentioned, is I have further diluted the KCl with about 50cc NS. If slowing the rate alone does not work, then I add the NS and that does the trick. Good luck!

That sounds like a good idea, I think I will pass that along to our pharmacy,

thanks for the tip! :)

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Specializes in oncology, surgical stepdown, ACLS & OCN.
What I have done in the past as someone else mentioned, is I have further diluted the KCl with about 50cc NS. If slowing the rate alone does not work, then I add the NS and that does the trick. Good luck!

That sounds like a good idea, I think I will pass that along to our pharmacy,

thanks for the tip! :)

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