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James Merritt
Concurrent flow during piggyback administration.

I would like to hear some of the methods some of the field nurses deal with concurrent flow of the primary line during piggyback administration? For those not familar with the term, concurrent flow is when you observe intermitted fluid flow (several or a couple of drops) in the drip chamber of the primary line during your secondary piggyback medication administration. How many of you feel that this is a huge issue, and what would your actions be it you were to see this occuring? Lynn this is directed to you as well, please refer me to any articles or literture you may have on the topic.

When I have seen this in

When I have seen this in clinical practice, I have always turned the back check valve upside down and tapped it. A small air bubble floats out that was trapped during the priming of the set. This bubble is usually what is preventing the valve from working. Once it is removed, there is no problem with the valve shutting off the flow from the primary fluid container.

If the medication is piggybacked low or close to the patient, this valve does not function so there will be concurrent flow of both fluids. If there is no compatibility issue there is no problem with concurrent flow in my opinion.

I don't remember ever seeing any articles on this issue though, Thanks, Lynn

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

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

concurrent flow

A quick remedy is to add another hanger to further lower the primary fluid. Nancy

Nancy Rose 

James Merritt
Concurrent flow remedy


Your answer was what I was looking for, would you consider concurrent flow an huge issue with a IV set? Also how often do you think concurrent flow is even noticed by the clinician?

James C. Merritt Jr. RN, BSN, MBA
Sr. Medical Device Specialist
Global Clinical R&D
Hospira, Inc.
275 N Fields Dr.
Lake Forest, Il 60045
224 212-6123 Wrk
773 910-2281 Cell

Gwen Irwin
Concurrent flow during piggyback admin

I am not sure that I totally understand the question, but based on what I understand I will answer.

Some of the pump design prevents primary infusion totally and allows the intermittent fluid to flow.  Are you talking about pump issues related to primary vs. intermittent?

Based on the pumps that we use, I do not see this as an issue.

Gwen Irwin 

Peter Marino
Physics, fluid dynamics

What worrries me in this situation is the position of the bags relative to each other. Is there a possibility that the piggyback will contaminate the primary or the primary will dilute the piggyback? Is the Pt. fluid restricted? Hence the use of a hanger to avoid fliud from bag mixing with the other.

Peter Marino R.N. BSN CRNI VA-BC Hospital based staff R.N. with no affiliation to any product or health care company.

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