Why not give IVPB alone?

Esme12, ASN, BSN, RN · Feb 22, 2014

some are given alone but they are always mixed in a solution to dilute them for infusion. Why do you ask?

prenurse101 · Feb 22, 2014

Well my friends are in level 2 nursing and are administering meds. they were talking about a patient having an ivpb and dextrose/nacl solution administered together. From what one said, all patient with an iv started are given fluids through iv and when they need meds that have to connect it to the fluid line to get it. The answer just sounded weird. But i dared to asked because i didn'twant to seem stupid. lol

Esme12, ASN, BSN, RN · Feb 22, 2014

Most patients do have a concurrent infusion of an IVF but it isn't absolutely necessary.

shantel1621 · Feb 22, 2014

I'm not sure you are asking the right question. IVPB is your secondary line that is connected to your primary line hence the name"piggy back". IVPB are usually used in the following cases: 1. pt. on around the clock meds ex. Q4H( to reduce loss/waste of supplies), 2. for medications that cannot be pushed b/c of its high concentration or cardiac/renal implications, 3. to reduce unnecessary disconnection of IV tubing especially in patient with central lines.

**NICU Guy, BSN, RN** · Feb 22, 2014

IVPB meds are on the secondary line of IV pumps. Some IVPB meds are given alone and the primary line (normal saline) is stopped. When the IVPB med is done, the pump will restart the normal saline at the set rate when it was stopped. Other IVPB meds are given concurrently, meaning if you have a IVPB running at 50mL/hr and a normal saline running at 100 mL/hr, then the pump will dispense 2 drops of NS for every 1 drop of the IVPB med. They are still getting the same amount of drug during the hour, but the second option gives the patient more fluids during the hour.

akulahawkRN, ADN, RN, EMT-P · Feb 22, 2014

Another way to look at is that if you have a med that's in a PB, you can set it up to run for a certain amount of time, the med goes in, then when the PB med runs out, the primary bag takes over and essentially flushes the line of the med and prevents the line from clotting off. Where things get interesting is that most pumps are set up only for 1 line per channel, so "selecting" which bag is the rider is done by gravity. The higher bag gets drawn from first. Some pumps have 1 channel but can handle 2 lines and can run them concurrently. Those have a 2nd port on each pump cassette.

Can IVPB meds be given all by themselves? I would venture yes... but why? By definition of PB, you already have an existing line...

Esme12, ASN, BSN, RN · Feb 24, 2014

Your existing IV line is the saline lock.

In infusion rooms and ED's across the country....IVPB antibiotics are hung (piggybacked) right into the saline lock IV line. When someone, as an outpatient, is having repeat IV antibiotics a new IVF isn't begun every time. The patient comes to the ED. The line is checked for patentcy. The IVPB is begun to the capped IV site. When the med is infused the IV is once again flushed after the med infused and secured for discharge for the next dose. The patient is then discharged. Hanging a new primary bag of IVF each and every time isn't necessary and expensive.

MunoRN, RN · Feb 24, 2014

Your existing IV line is the saline lock.
In infusion rooms and ED's across the country....IVPB antibiotics are hung (piggybacked) right into the saline lock IV line. When someone, as an outpatient, is having repeat IV antibiotics a new IVF isn't begun every time. The patient comes to the ED. The line is checked for patentcy. The IVPB is begun to the capped IV site. When the med is infused the IV is once again flushed after the med infused and secured for discharge for the next dose. The patient is then discharged. Hanging a new primary bag of IVF each and every time isn't necessary and expensive.

I've always thought "piggy back" referred to a secondary infusion and not a y-sited infusion, maybe we need to just abandon the term.

Our outpatient infusion which typically gives just a single dose always sets up a primary/secondary (with just a 100ml primary bag) due to the loss of medication with priming and residual remaining in the line.

BluegrassRN · Feb 27, 2014

We give IVPB all the time without accompanying fluids. Just depends on the physician's orders and the pt's status. Some antibiotics are hard on the kidneys, for example, and until the physician has a day or so of oral intake data on the pt, we keep them on iv fluids as well as iv antibiotics. Or the pt has electrolyte imbalances, or their lab work indicates dehydration. Lots of reasons to run fluids and iv antibiotics together, but not all those reasons apply to all pts, and some pts simply don't need fluids, so they don't get them (pts with chf, for example). Does that answer your question, OP?

and yes, I know IVPB technically means piggyback, but in our facility it simply means an intermittent infusion, and I assume it means that in most. When you piggyback the other fluids aren't running concurrently, anyhow.