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Discussion

Y-site issue

Hi so I am an infusion nurse and was recently orienting a new employee and this issue came up. I have a patient that receives a therapy at 100 mL an hour for about 4 hours and also receives a concurrent infusion of saline at 200 mL/hr. When I first admitted the patient I decided to y-site the infusion to the patient's port. The new employee pointed out to me that although I set two different rates on pumps that when the two infusions get to the y-sited area they mix and the slower therapy can be carried along at the faster rate or there can be backflow issues. Obviously the best solution is to start an IV and ensure that the two therapies are administered at the proper rates. However, the patient is a hard stick and is resistant to this idea. Also, the patient has been tolerating the infusion this way for years. Has anyone encountered this problem? Should I insist on starting another line? or continue as is?

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    I do not think it's much of an issue as long as both the saline and the medication are on pumps, if there was an issue with fluid backing-up the pump would/should tell you there is an occlusion because it cannot move the fluid forward.

    I'm a little more concerned with the patient getting 300ml/hr for 4 hours :woot:

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    We have up to 3 or 4 drips running at once thru a trifurcated connector and extra stopcock, usually there isn't an issue.

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    We have up to 3 or 4 drips running at once thru a trifurcated connector and extra stopcock, usually there isn't an issue.

    I agree; I usually have Levophed, Fentanyl, Propofol and an NS KVO running together and never had an issue!

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    No issues as long as the two medications are compatible.

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    I do not think it's much of an issue as long as both the saline and the medication are on pumps, if there was an issue with fluid backing-up the pump would/should tell you there is an occlusion because it cannot move the fluid forward.

    I'm a little more concerned with the patient getting 300ml/hr for 4 hours :woot:

    Please remember that 300cc an hour x 4 hours is 1,200 cc. That is 5 cups of fluid in a 4 hour period. Depending on the patient's age, and comorbidites, that may not pose a problem.

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    The patient is still only getting the drug at 100 mL an hour or whatever it is set at since that is the amount that is ending up at the Y site. Not sure how to explain it. So if 100 mL an hour equates to 20 mg of drug, only 20 mg of drug per hour is getting escorted by the NS since that is all that is getting pumped into the y site by the pump.

    Annie

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