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gsbrn
Backpriming secondary lines vs. seperate tubing for secondary infusions.

We're updating policies and this question came up.  Is it better to backprime secondary tubing and use one set of tubing for all piggyback infusion (to avoid opening the system) or is seperate tubing for each piggyback med preferred?  I can't find any literature on the subject.  Is incombatibility/precipitates a concern or will the medicaion from the previous infusion be diluted enough during the backpriming process to eliminate that concern?  What is everyone else doing with reagard to this?

Greg Bowman, RN

Clinical Supervisor

IV Therpy

Swedish Medical Center, Seattle

lynncrni
The backpriming method is

The backpriming method is the most cost-effective method and it allows you to adhere more closely to the INS standards of practice. Drug compatibility must always be a concern.  The issue with the compatibility between the secondary med and any medication added to the primary fluid. If no med in the primary fluid, there is no problem. If backpriming is not done and these secondary sets are connected and disconnected with each dose, they should be managed as intermittent sets and changed every 24 hours. 

Lynn Hadaway, M.Ed., RN, BC, CRNI

www.hadawayassociates.com

Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

gsbrn
Thanks for you response,

Thanks for you response, Lynn.  My concern was not between primary IV fluids and secondary meds as much as it was between one secondary med and another.  If two antibiotics, which are incompatible, are infused through the same secondary tubing, even if it's been backprimed with the primary fulids, is there still a concern for precipatates or is that mitigated by the dilutional action of the primary fluid?

 

Greg

lynncrni
Backpriming with the primary

Backpriming with the primary fluids should flush all of the residual from the first dose back into the empty fluid container which is then detached. There have been no reports to my knowledge of drugs adhering to the plastic tubing and then causing drug precipitate problems. So the only real concern for compatibility issues is between the secondary med and any drugs that are admixed in the primary fluid. This could be vitamins, heparin, insulin, plus numerous other drugs. For this reason many hospitals use a bag of plain normal saline as the carrier fluid, piggybacking all meds into the saline line which is then attached to the primary line. 

Lynn Hadaway, M.Ed., RN, BC, CRNI

www.hadawayassociates.com

Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

gsbrn
Thanks for your

Thanks for your clarification on that Lynn.

 

Greg

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