Question about IV piggyback

[ppppf]

I'm from another country with experiences and recently got a license in the U.S.

Hand dripping was common in my country and I'm not familiar with the IV piggyback we do here in the U.S. so please let me ask.

Pt has one IV line and is receiving LR as continues IVF and there is an order of IVPB (incompatible to LR).

In this case, I think I should set up IVPB with .9NS as a primary line, hold LR while I'm infusing the IVPB. Or insert another IV line then infuse LR from one line and infuse IVPB from another line.

My preceptor set up IVPB with .9NS as a primary line, connecting the tubing to the LR's line below the IV pump, and started both at the same time. IVPB will be mixed with LR in this case.

please let me know which scenario is right. Thank you,

[Okami_CCRN, BSN, RN]

In a situation where you described (IVPB medication being incompatible with primary IVF) I would stop the primary IVF, disconnect primary line, red cap/dead end the line, flush IV and connect the IVPB medication with a compatible solution for the duration of the infusion. 

 

[Been there,done that, ASN, RN]

The correct answer is whatever your preceptor is teaching you, 

[SnickRN BSN RN CCRN]

Your thinking is right.  If the meds are incompatible, they shouldn't run together.  Depending on the length of the time of the IVPB infusion determines your next steps.  If the medication is a short duration,  disconnect the LR, run the med, the restart the LR. If it's a long run IVPB, start a second IV for the IVPB. 

You should have a pharmacist who can help with compatibility and checking your online resources. Preceptors aren't always right as they could have been taught wrong or, I hate to say it, don't care and just follow orders. We are the safety net for our patients. If it doesn't seem right, ask someone: your educator, charge RN, another nurse. Even though you have a preceptor, you are ultimately responsible for you cares & its your license & job. 

[ppppf]

Thank you very much for the clarification!