Glou

Like @MunoRN I don’t think I mixed if I flushed prior and the patient had no reaction fortunately from what I was told by day shift RN at least 5 hours from when it happened. I believe that’s a good sign that everything is OK. There should have been a reaction by then no? But I’m gonna ask her again later. I don’t believe I needed two different IV sites. (One less poke for the patient! LOL) I just needed to disconnect/flush before and after instead of just clamping the other port and infusing through the tubing to risk any possibility of mixing incompatible meds.

Oh I totally understand! In this case, the sodium bicarbonate was at 125 but yes definitely need to consider the rate too and most of all prevent mixing incompatible meds!. Thank you so much for responding btw! Definitely will learn from this to be even more so careful. I generally think I am pretty careful and recheck everything especially making sure nothing is clamped. But I keep reminding myself I’m only human. But my main concern is always the patient. Thank you again.

@MunoRN Ahh that’s what I meant same lumen but with two different ports! Thank you for replying! I appreciate it. I guess I just wanted another opinion or some reassurance that one flush was enough to prevent any precipitation or anything like that especially since I did it from the nearest port on the tubing and didn’t disconnect. These thoughts or questions will kind of dwell with me well after a shift so thank you!

Hello! First time asking here. I just had a question regarding incompatibility of meds. I was using a peripheral line for a patient. One lumen was getting sodium bicarbonate and the other was getting NS TKO. If I had to give a med that was incompatible with sodium bicarbonate I just clamp the sodium bicarbonate at the IV site and use the closest port of the TKO line flush with 10cc of NS and then give med then flush again then restart the bicarbonate. however this time, I was not as cautious as I usually really am and mixed up my lines. So I clamped the NS line (unknowingly). Paused the bicarbonate. Then flushed from the nearest port 10 cc and gave zofran (incompatible with sodium bicarbonate). I was more than halfway giving this med IV push when I realized I was using the wrong line. So I stopped immediately. Clamped the line. Flushed NS in the TKO and pushed the rest of med in the TKO Line. I changed the whole tubing of the sodium bicarbonate bag. I immediately checked the patient she had no pain. At first the site I thought looked swollen but it seemed fine. I got blood return ( with difficult but there was blood return nonetheless). So I figured it would be okay. I told the next nurse the situation and to keep an eye on it. I texted her if she could let me know if the patient is okay and her arm is fine. During this time I could not sleep when I got home. She texted me a few hours later and told me pt was okay and no issues with her arm. (Sorry this was so long). So I guess my questions are does that mean I no longer need to worry? She would’ve reacted by now right? Like she would have been in pain or her arm would have been infiltrated or extravasated. Does the fact that I flushed 10 cc at the closest port in the sodium bicarbonate line prior to the incompatible med zofran help?