Question on piggybacking med

[lil one]

When you are hanging a piggyback to infuse with another solution how do you set it up so that it will pull both? For example, If you are ordered to hang magnesium sulfate on your saline locked patient. I was told that you nee to piggyback the magnesium sulfate into LR and run at 50/hr. so doesn't that mean that the LR and Mag need to be infused together? How do You set it up so that the pump will pull both fluids. I know usually you raise the piggyback higher, but then won't it only pull the mag by itself? I'm just confused on how to set this up. Please help!

[FiduciaRN]

On the pumps we use where I work, if you want two solutions to run at the same time, we set the pump to run concurrently. That way if I am running say heparin and nitro it will run in together. Hope this helps.

[iluvivt, BSN, RN]

This also depends on your pump...on some pumps if you set it up as a secondary piggyback so it is connected above the port at a Y-site...you have to select secondary..that will run in and then switch over to the primary when completed. If you have this kind of pump you would need to piggyback it in at below the pump..either by syringe pump or volumetric pump. Most pumps that I have seen work this way. You can also attach below the pump and run by gravity and leave the primary on the volumetric pump

[dragonflyaltoids]

I did this then realized I hadn't opened my tubing to run, until 20 minutes later, ooops! Well, I learn from mistakes! Glad it didn't hurt the patient!

[TamekaRN]

I agree, it does depend on the type of pump. I usually do a simlar connection when I wasnt to dilute, say potassium with normal saline. As we know potassium is hard on the veins, so you would want to dilute it. The pumps we have you can program the primart to a KVO, but secondary(piggy back of mag) will run. but of course you can't run so much saline at KVO so I usally hook up another module to the pump system and run that into the y-connection at say 30. That way you have the dilution from the primary and the saline directly into the Y-port. Hope this helps.

[Asystole RN]

Attach the piggyback on the tubing somewhere between the pump and patient and allow to infuse. The pump will still pump your primary at the given rate and the piggy secondary will infuse at whatever drip rate you determine.

Connecting the med above the pump you can make the pump draw from the piggy back first, then primary. Below the pump they both go in the same time at different rates.

[MOJO_RN]

Could you change the IV to a y-port and run in both concurrently via a double pump?

If you wanted mag and NS to run in together, I think what I would do is spike both bags, set the NS on one side of the pump to run in at KVO (or w/e flow rate is ordered) and the mag on the other side at the prescribed rate and run both tubes to the y-port.

Or am I just way off base here?