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Hanging an IV Piggyback

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Overview

  1. Purpose
    1. Some IV infusions are hung as secondary, or piggyback, infusions with primary infusions of IV fluids
    2. This method ensures all of the medication is infused
    3. It also ensures the primary infusion is restarted immediately once the secondary is complete

Nursing Points

General

  1. Supplies needed to hang an IV piggyback
    1. Primary infusion – already spiked, primed, and infusing to patient
      1. Ensure fluids are compatible
    2. Secondary tubing
    3. Bag of med for piggyback infusion

Nursing Concepts

  1. Steps and Nursing Considerations
    1. Verify provider order
    2. ALWAYS follow 5 rights BEFORE preparing medication
      1. Right Patient
      2. Right Drug
      3. Right Dose
      4. Right Route
      5. Right Time
      6. Right Documentation
    3. ALWAYS prepare medications at the patient’s bedside
    4. Gather supplies
    5. Perform hand hygiene
    6. Don clean gloves
    7. Let the patient know what meds they will be receiving
    8. Remove IV med bag from package if applicable
    9. Open Secondary IV tubing package
    10. Clamp tubing with roller clamp
    11. Spike and prime the tubing appropriately
    12. Clamp tubing once fully primed
    13. Attach the secondary IV tubing to the port on the primary IV tubing that is above the pump
      1. Scrub the hub for 30 seconds with alcohol scrub
      2. Twist the leur-lock in place
    14. Set the pump for a secondary infusion per manufacturer instructions and according to the ordered rate
    15. Unclamp the secondary tubing , THEN Start Infusion
    16. AFTER administration
      1. Document administration
      2. If using barcode medication administration
        1. Scan all meds before preparing
        2. Confirm administration AFTER giving to patient
    17. Discard all used supplies
    18. Remove gloves
    19. Perform hand hygiene

Patient Education

  1. Indication and possible side effect(s) of medication(s)
  2. Signs to report to nurse or provider

Reference Links

Study Tools

Video Transcript

In this video we’re going to look at how to hang an IV piggyback, otherwise known as a secondary IV infusion. To do this, you have to have a primary infusion running, so make sure you go back and watch how to spike and prime an IV infusion first!

So once you’ve verified your orders, you’re going to get your IV med bag out of the package if it’s in one.
Then you’ll open the secondary IV tubing package – this is usually much shorter than primary tubing and doesn’t go inside the pump. Then you’ll clamp that tubing once you have it open.

Then you need to spike and prime your secondary med bag – use a trashcan or the sink if you need to, then clamp it once it’s primed.

Now you’re going to attach the secondary IV tubing to the primary tubing – usually there’s a port above the pump, that’s where you want to attach it. Make sure you scrub the hub.

Now you can set the pump for a secondary infusion. If you aren’t sure how, check the manufacturer instructions or check with a charge nurse. Ad of course, make sure you’re setting it according to the ordered rate.

And, of course, make sure you unclamp the secondary tubing before you hit Start!

If you’re ever unsure how long to infuse these meds over, check with your pharmacist. Then, document the administration and monitor the patient for effects of the meds.

That’s it! Now, go out and be your best selves today. And, as always, happy nursing!

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