Set up for IVPB

[Bec717]

A few questions~

I go to add an IVPB to an existing line and I am a little confused~

1. Determine drop factor based on tubing size, amt. of meds, and time.

So for this example I use 16 drops per minute

2. Set primary chamber to 16 drops per minute (do I then clamp this line or let it continue to flow)

3. Spike IVPB bag and hang higher than primary bag, but be sure roller clamp is closed.

4. Next, squeeze and fill the IVPB chamber to allow to fill about 1/2 full.

5. Now I get confused- do I prime the line for the IVPB or add the needleless connector device to secondary tubing?

6 Then either prime line or add needleless device?

7. Wipe Y port with alcohol and attach needleless device and open secondary roller clamp to start flow.

Step 5 and 6 is my question or do I have this enitre concept completely out of sequence?

Thanks~

[beth66335, BSN, RN]

Here is a link to a PDF set up list. http://davisplus.fadavis.com/wilkinson/PDFs/Procedure_Checklists/PC_Ch23-24.pdf

[Daytonite, BSN, RN]

here are several other links:

• http://connection.lww.com/products/evans-smith/skill%205-10.asp - pictorial of administering iv medication by piggyback, mini-infusion pump, or volume-control administration set
  
• http://www.mccfl.edu/print/2482.asp? - one hospital's procedure for administering ivpb medications into a primary iv line
  
• http://myphlip.pearsoncmg.com/altproducts/demo/ab2page.cfm?vbcid=7006&vid=2277

i always primed my piggyback tubing first, then attached it to the primary line at the y-connection above the where the tubing goes into the iv pump or hanging it above the primary bag if it is a gravity drip. there should already be a needleless connector at the y-port on the iv tubing. if not, then put one there. then open the roller clamp on the piggyback tubing. physics does the rest.

[PreemieNurse]

Bec, are you talking about a gravity flow or an IV on pump?

If you are hanging a brand new PB to an existing line on a pump (or gravity, doesn't matter) attach secondary tubing to PB bag. Using needleless port closest to IV bag on primary line (above pump), attach secondary tubing. You do not need to forward prime if using new tubing, simply "backprime" the air into the PB bag.

On a pump, you can leave your primary IV running while doing this. If you are using a PLUM pump, you have to stop A to backprime. Once done backpriming, restart A. Program B, then start B. A will be paused until B is done.

If gravity, adjust your drop rate by clamp on primary line.

I am a skills instructor so please let me know if I can be of further assistance. Hope my written explanation helps.

[Bec717]

Thanks- you provided all the info I needed!