Terminology

• Piggyback: general term meaning ‘attach 1 tubing to another’

• Continuous vs Intermittent• Secondary Tubing• Y-site• Volume Controlled set

1

Advantages IV route

•Direct (and instant) access to circulatory system

•Able to give drugs too irritating for gastric mucosa – or for delivering high concentrations

•Since IVPB (“intermittent”) usually over 30 – 60 min, can instantly d/c if reaction occurs

•Able to give meds when GI tract not available

2

Disadvantages of IV route

• Drug interactions because of incompatibilities

• Sometimes drug absorbed by plastic container – full dose not delivered

• Speed shock• Tissue injury – chemical phlebitis or

when certain drugs infiltrate

3

Before hanging med:

• Check expiration date on secondary tubing.

• Does tubing have sterile cap?• 5 rights, plus

– rate of administration– compatibility of IV solution

• clean access (Y-site) ports with alcohol prior to each access.

4

Compatibility & Rate of Administration

Drug books• Davis’s Drug Guide: each drug divided into

sections; find “IV Administration” section– “intermittent administration” &

compatibility• Gahart: information under Dilution, Rate

of Administration, Compatibility– Intermittent IV (vs IV injection or

infusion)

• Pharmacy 5

Ondansetron HCL (Zofran)(Gahart & Nazareno, Intravenous Medications)

Dilution• IV injection:…• Intermittent infusion: single dose should be

diluted in 50 mL of NS or D5W. Also available…

Compatibility• Additive• Y-site

Rate of Administration• IV injection…• Intermittent infusion: single dose over 15 min.

6

Primary IV on Infuser pump

• Y-site above the pump (‘rate controller’)

• Backprime• “piggyback” or “secondary”

function key• Rate• VTBI

7

Primary IV to gravity

Dial-a-flow or stat-master = the ‘rate controller’

• Y-site above rate controller• Set at desired ml/hr AND check gtts/min to

verify accuracy.

Maintenance solution stops while infusing an intermittent med attached above the pump or dial-a flow

8

After hanging med

• Make sure it is infusing– Have you opened the clamp?

• Check on pt after 5-10 min• 6th right: document

9

Syringe Pump

• “spaghetti” tubing• Note where flange of syringe goes• Attach closest to IV insertion site (below

the ‘rate controller’)• Maintenance solution does not stop

10

Saline Lock

• Saline

• Administer med

• Saline

• Used with Syringe pump, gravity tubing, or EID

What if solution is incompatible?

• Use Primary tubing and connect to lower Y-site– Turn off primary IV– Flush with saline before and after

or• Disconnect primary IV, hang NS

and use secondary tubing.

12