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.

Specializes in Emergency.

at my Er we usually inject lido into the bag, and some at the closest port on the IV, ( forget how much, at this time)

xo Jen

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Specializes in Emergency.

at my Er we usually inject lido into the bag, and some at the closest port on the IV, ( forget how much, at this time)

xo Jen

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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.

Although I have ready numerous posts about adding 1% or 2% lidocaine to a potassium rider, at my hospital the nurses can request that the doctor order "Neut". The revised order is sent to pharmacy where the required potassium is combined with saline and sodium bicarb to create a painless piggyback. Everyone is happy, including the peripheral veins. :)

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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.
.

Please send me the answer

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why don't you try a larger vein. also, don't dump all of your iv's into the same vein if you can help it, give it a rest!. Be sure to flush and check for blood return before, and flush after. If all else fails, ask the doc to prescribe an additive to reduce the pain. Oh, and also, can some of it be given orally or per tube? You may have to go to a central line if the patient's condition is so fragile that you are constantly replacing potassium.

Be sure to constantly assess for fluid overload if you increase the fluid volume as you have suggested. Does the patient have a bad heart or CHF?

good luck!

It seems like it would be easier to just give PO k+ but when the patient complains of burning, I do like the originator of this thread and run it (with a second pump) as a primary so that it is mixing and being diluted by the primary, rather than as a secondary substituting the primary. I have also worked in a hospital where lidocaine was added. I don't know why the docs don't use this at my current employment. The pharmacy added the lidocaine, reducing the chances of dosage errors.

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We run it as slow as possible and also try for the larger vein.

But I find adding the 'neut'/bicarb very interesting and am curious how much is added per bag. Our IV K+ replacements are premixed 10 mEq per 100cc, so does anyone know the standard amount of bicarb that would be added to this mix? Thanks!!

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We use "neut" 5% in 1ml ampules. The doc generally orders one to two amps per bag of IVF, depending on concentration of K+/ml. We use many different sizes and concentrations at the hospital.

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We use "neut" 5% in 1ml ampules. The doc generally orders one to two amps per bag of IVF, depending on concentration of K+/ml. We use many different sizes and concentrations at the hospital.

"Neut" just stands for "Neutralize with NaHCO3," right? Or is "Neut" the actual name of the product?

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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.

who uses the pre made ones from a drug company?

i have noticed that those seem to get more complaints than when we used to just mix it ourselves!

i'd love to see if premade ones are more problematic.

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If you look in the drug book under sodium bicarbonate, it lists different strengths and different names. Neut is one of the names, it is NaHCO3 packaged specifically to neurtralize the burning of certain antibiotics and potassium.

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I work in MICU.... we run 40 K+ in 100 NS in a central line over 2hrs...We can run 20 K in 100NS in 30min to 1hr via central line.... in a peripheral we'll run 20 over 2 hrs.....I hardly ever get orders to run 10....

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I work in MICU.... we run 40 K+ in 100 NS in a central line over 2hrs...We can run 20 K in 100NS in 30min to 1hr via central line.... in a peripheral we'll run 20 over 2 hrs.....I hardly ever get orders to run 10....

Running 20-40 meq KCL makes sense...though it can only be done with a central line...but 10 meq is just frustrating! It takes an hour to run in into a peripheral line and you know you could get 20 meq PO on board quicker than you could the IV (2 hours).

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