Question about IVPB

dream'n, BSN, RN · Jul 25, 2015

Depends on where the Antibiotic is attached and if it is on it's own pump. If you want your primary fluid to infuse with the antibiotic at the same time, you place each on it's own pump and Y in your antibiotic to the port close the the patient (make sure of compatibility). BUT if you are doing a true IVPB and attaching the antibiotic to the port above the pump, it must hang higher. That way the antibiotic will run in first and then be flushed or switched over to the primary fluid.

MunoRN, RN · Jul 25, 2015

Intermittent infusions, particularly antibiotics, should be run as a secondary, which means it attaches to the secondary port of the primary or carrier infusion which is the one above the pump. This is so that the primary or carrier infusion (compatible with secondary) is what gets wasted in priming and residual in the line, otherwise it's not uncommon to lose up to have the dose of antibiotic. The pump doesn't control which bag it's draining, only the height of the bags controls this.

Creamsoda, ASN, RN · Jul 26, 2015

It can depend on the pump. In our ICU the pumps we use would require hanging the ABX higher than the saline and the ABX would hook into the secondary port. But the rest of the hospital uses different pumps and those ones it doesn't matter, the pump somehow runs both of them and it doesn't matter on the height.

britpanda · Jul 26, 2015

I think the answer to this lies in the pump being used. In our facility we are able to hang the bags at the same height because the pump pulls from the secondary line when set up as a piggyback with NS as the primary line regardless of the heights of the bags.

calivianya, BSN, RN · Jul 26, 2015

Are you using the Plum pumps? We have those at my PRN job and it doesn't matter if one bag is higher than the other. The Plum pump can even run both lines plugged into it concurrently, so the maintenance fluid does not have to be paused for the ABX to run.

Every other pump I've used, the one running as a piggyback needs to be higher than your maintenance fluids.

Caffeine_IV · Jul 26, 2015

We use Plum pumps as well and you can hang the lines the same height.

britpanda · Jul 27, 2015

Sorry, should've specified that we use Plum pumps in our facility

Trauma Columnist · Jul 27, 2015

Moved to Nursing Patients and Medications

PVL_RN86 · Jul 28, 2015

Hi everyone, thank you so much for your responses to my question. I'm a bit confused because I was always taught that no matter if a pump is used to infuse the antibiotic, whenever giving antibiotics via IVPB-- the antibiotic is always hung higher and the secondary bag is lower.. All of your response have helped me tremendously gain more insight on this matter...

I'm a new RN and will definitely be questioning this with my workplace as I'm on orientation..

Also, your responses might explain to me WHY I have been seeing a LOT of IV antibiotics with some fluid left inside them without properly being infused all the way... This to me means that the patient likely is not getting their full dose of antibiotics. Again, thank you!!!! :)

IVRUS, BSN, RN · Jul 31, 2015

Yes, seeing an IVAB with fluid in the vial, or even worse, when the drug and its diluent weren't mixed in the first place, frustrates me too, to no end. Also remember that a complete dose means that the ENTIRE bag is empty, but there still should be fluid in the drip chamber and the IV tubing below it. Surveyors will easily tag you if they come in to see the IV antibiotic hanging and it still has mixed drug in its diluent in the bag.