UVC, TPN, Antibiotics questions

[Obnurseamber06]

I work at a level 2 nursery facility. We do not deal with alot of UVC's but recently we've had quite a few more. I've heard mixed information on different things with UVC's and was just wondering how things are done in your facility.

While infusing TPN through a UVC how are antibiotics given?

[theatredork]

Typically, we run TPN through a tri-set, with TPN one of the filtered ports, and lipids on non-filtered port, and the remaining medline port primed with a normal saline flush. We give meds through the medline port. We connect the tri-set directly to the UVC without a stopcock to avoid confusing it with the UAC. Hope this helps, and that it makes sense.

I've given Vancomycin, Gentamycin, Oxacillin, and Cefazolin on a syringe pump thorough a tri-set with TPN and Lipids running.

[RNN09, BSN, RN]

As SondheimGeek stated I have done that as well. Also if the baby has a peripheral IV then I give my antibiotics through that as well.

[littleneoRN]

The principles here aren't much different from a peripheral IV. Ampicillin is incompatible with TPN, so if you only have one lumen and no other access, TPN would need to be stopped, line flushed, ampicillin given, line flushed, TPN restarted. On a really small baby or baby very sensitive to changes in glucose, it may be necessary to hang D10 (assuming your TPN is 10% dextrose) while your TPN is stopped. Otherwise, other antibiotics can just run in a trifuse as previous posters suggested.

[jlb_rn]

We treat a UVC as any other centrally placed line and bi or trifuse fluids as needed; if it's a double lumen, we'll run continuous sedation via the UVC as well. The hospital at which I work does not run antibiotics centrally unless we are treating a line infection. Antibiotics and other non-continuous meds are infused via a peripheral IV.

[littleneoRN]

We treat a UVC as any other centrally placed line and bi or trifuse fluids as needed; if it's a double lumen, we'll run continuous sedation via the UVC as well. The hospital at which I work does not run antibiotics centrally unless we are treating a line infection. Antibiotics and other non-continuous meds are infused via a peripheral IV.

Out of curiosity, why? We love it when we have a UVC or PICC because it's stable access, even for things that don't need central infusion. Do you do this to reduce accessing the line and prevent infection? I would just hate to have to keep up PIV access when I have a perfectly good line and no contraindications for running these particular meds via UVC.

[jlb_rn]

Do you do this to reduce accessing the line and prevent infection?

Yes - instances where peripheral access is an issue, the docs will consider ordering meds centrally.

[EmilyPeruana]

i work in a level 3c nicu. it's nice to have a picc line in as soon as possible obviously...but until then, it's nice to have a double lumen uvc if possible....if not, you can give most meds through uvc with tpn...there are some that aren't compatible...like amp...but you can just stop tpn...flush/slow push amp/flush...and you're fine...but if you have a fent drip...or dopa/dobuta...prostins...you're not going to want to do that...so a back up piv is preferred...also...you really only want a uvc for about a week...you dont want any chances that it can clot off...the faster you can get a picc line placed, the better so that you can get that uvc out...good luck!