Run them at the same time?

SuesquatchRN, BSN, RN · Dec 19, 2007

That just seems like a nightmare should any sort of infiltration or extravasation occur, or reaction, no? How do you know what's responsible?

rnrae · Dec 19, 2007

Thanks Suesquatch. It did sound like a scary thing to do.

GrumpyRN63, ADN, RN · Dec 20, 2007

The only atbx's I ever mixed together were Gent and Clinda back in the day when we used buretrol's they were put in together, other than that, never mixed anything

anonymurse · Dec 20, 2007

Had a patient who had 5 different abx ordered, some of them for the same time. Is it safe to run them at the same time, on extension tubing, assuming they are compatible? I have gotten different answers to this question.

Does he have a good IV site in each arm? If not, you might want to "upgrade" him. That would simplify your problem a good bit.

bradleyshanetaylor · Dec 20, 2007

that or you could try to stager the meds so that they go in at different times. or if they have had the meds before have an iv in both arms and run two in at once.

MedicalLPN, LPN · Dec 20, 2007

I wouldn't give them together through the same IV site. A lot of times I'll have a Zosyn and a Cipro due at the same time, with us Zosyn takes 30 mins to run through and the Cipro 1hr so I just run the Zosyn first then run the Cipro once the Zosyn's finished. With him getting 5 antibiotics I would start a 2nd IV site.

registerednut1221 · Dec 20, 2007

I don't see how you could physically hang all 5 at the same time...believe me I have had this argument with pharmacy many many times BUT if your patient has a PICC line you can run antibiotics on different ports at the same time even if they are incompatible. With that being said, I do try to stagger the meds as best I can within the time allowed (we have an hour before and 2 hours after).

MichaelFloridaRN · Dec 20, 2007

Sometimes when I have a central line or PICC and still and have a backup peripheral IV, I will run two at the time. Even if they are "compatible", it normally means one can be run with the other, I doubt they ever run tests mixing several different ones with each other.

I personally would see 5 med anythings to run at the exact same time a reason to call the doc and ask if we can reschedule the times to run them one after the other.

Worst case would be to have a reaction, and not knowing which agent is causing the reaction and then not being able to give any of the meds for safety reasons, possibly putting the patient at risk not only to anaphylactic reaction, but not receiving much needed treatment Make sense?

rnrae · Dec 20, 2007

I had to pull his PICC due to infection at the site. It was nearly impossible to get a peripheral in him but I did. It just doesn't make sense to schedule all of the abx at the same time. If he is still there today, I will ask the doc to reschedule them.

Tait, MSN, RN · Dec 20, 2007

You can probably just call your pharmacy and tell them to reschedule it. They generally set up generic times, not the physician. I have noticed that they don't often realize they have two, three five scheduled at the same time until you point it out.

I think it is safer to have abx running all day then taking the risk of multiples at one time.

meandragonbrett · Dec 20, 2007

I would just re-time the meds on the mar. Only time would I have more than one abx going at the same time is if we're talking septic shock and first doses of abx are being given. If you're running 2 or 3 abx and your patient has a reaction, how can you know which abx caused the reaction?