I haven't seen any information about this on the forum since 2008, and do not see any info in the latest INS infusion journal. Can 2 incompatible medications be infused simultaneously via a double lumen PICC? Can I get help with reference for this? Thank You very much
This is not a good idea as there can be contact as the meds exit the catheter lumen. While they are no in contact inside the administration set or catheter lumen, it is possible to have a precipitate formed at the catheter, especially if the reason for the incompatibility is a wide variation of pH between the 2 drugs. I doubt you will find any research on this. Think about the logistics of actually showing this precipitate in the bloodstream. Drug compatiblity testing is done for 3 situations - mixing in the same fluid container, mixing in the same syringe, and mixing at a Y injection site. Why is is necessary to infuse both drugs simulataneously anyway? If there is a reaction, you would not be able to determine which drug caused the problem. Lynn
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
I have been the IV Specialist since '95 for a Home Infusion Agency. I understand what Lynn is saying, but we have always worked on the assumption that it was ok to infuse 2 incompatibles because of the blood flow rate in the SVC. It seems highly unlikely that anything would mix. We rarely have this problem in the home, but we would handle it by infusing at same time. Would like to hear other thoughts on this.
We always give multiple incompatible meds at the same time via double or triple lumen PICCs..... in icu there are many drips that we are giving via central line and must be given at the same time; example; levophed, maybe heparin, bicarb, diprovan, tpn, etc..... they must all be infusing simultaneously... ... we have not had any issues..... hemodilution is the key and what we are feeling make it acceptable ....what would the other options be??? another picc line in other arm, physician inserted central line. ?? you would still have meds exiting the distal svc... or giving them peripherally which is even more risky.... I am certainly no expert but this is our process.
Gina Ward R.N., VA-BC