What do you call it? (Piggyback)

[applesxoranges, BSN, RN]

Ok, so multiple times I have had ER coworkers look at me like I am crazy when I try to explain how I set up my IV infusions but ICU and the floor seem to get it.

Basically, I say it is piggybacked into the mainline or bolus when it is connected to the bottom port closest to the IV.

Basically, I had to bolus a lot of fluid into a patient while keeping it at a certain rate so I had that running into the patient and then the antibiotics hooked into it at the bottom port but they were piggybacked into another solution to stay compliant with policy. All were in their respective channels on the pump.

[Altra, BSN, RN]

The difference in practice settings is why you're experiencing this disconnect. I've worked both ICU and ER, and I had to really work to mentally picture what you're describing. If a fluid bolus is already running, what is the rationale to set up additional fluids to run with the abx?

In the ER, a bolus is almost always - no pump, just wide open via gravity. You can piggyback abx or whatever else you need to to this line via pump, as long as it's compatible.

[NewMurse1014]

I think what you're trying to say (correct me if I'm wrong) is when you're giving a bolus or maintenance IVF and piggybacking an abx, the bolus/maint IVF would stop running until the abx is done (for certain abx like zosyn that runs over 4 hrs, the pt would lose 4 hrs of maint IVF). As the result, you piggyback the abx to a separate line, which connects to the bolus/maint IVF at the lowest port, so you can given the fluid and the abx at the same time using a single IV. I don't know if there's a specific term to describe this circumstance, but I would just say I'm running an abx that's hooked up to the lowest port of the main bolus/maint IVF line.

[cleback]

Yeah, different practice settings will set up infusions differently. What we consider "secondary/piggybacked infusions" on the floors are often run like primary bags elsewhere. ER, home health, infusion centers are some of the settings that do this that I can think of. It does make sense in their settings because the infusion is short term, there are no primary fluids running (usually)-- the antibiotic just needs to get in.

[MunoRN, RN]

"Piggyback" is not a very well defined term, it most often seems to refer to a secondary infusion but is also used to describe a primary infusion that is Y'd in to another primary infusion.

Unless the amount of antibiotic the patient actually gets doesn't really matter, which is pretty rarely the case particularly in the ED, it should be set up as a primary/secondary infusion.

[Caffeine_IV]

I call a piggyback when I hang the antibiotic or whatever medicine and the primary infusion is stopped.

Are you describing low porting? For example, I might low port a continuous low rate infusion like nexium (on it's on pump) with the normal fluids (if ordered) because they need the volume.