Central Lines and IV Push and Piggyback Medications



I have a patient with a triple lumen subclavian central line the patient has normal saline running through one pump hyper alimentation or H a running through this side of the double pump and vitamin b12 running through this side of the double pump as you can see the H a is running through this line the normal saline is running through this line and the vitamin b12 is running through this line the patient has been ordered to receive IV push Reglan IV piggyback nexium we've gathered my supplies with my alcohol preps entered the patient's room washed my hands introducing myself to the patient I will explain to her that she will be receiving medications I then want to ask her to state her name and date of birth as I'm checking her identification bracelet I will ask the patient if she has any allergies I have looked in the drug book and verified that both medications are compatible with normal saline I will begin with the IV push Ragland the first thing that I want to do is stop the pump that has the normal saline running through it the other two lines can continue running I want to go to the port on the normal saline line that is closest to the patient when administering an IV push medication I'm scrubbing the port with an alcohol prep I will connect the syringe to the port in a twisting motion for a complete demonstration on IV push medications see the IV push medications video after administering the IV push Raglan restart the normal saline now I will hang the IV piggyback nexium I have already checked to see that this is compatible with the normal saline IV fluids that are running I will hang the piggyback on the hook and attach the end of the piggyback tubing to the port above the IV pump or the port that is closest to the bag of IV fluids I will swab the port with an alcohol prep and attach the tubing I will now program the pump for the infusion I will go to the secondary volume to be infused the piggyback has 50ml so I will press volume to be infused 50 ml the rate is to run at 150 MLS per hour I will press the secondary rate then 150 then I will unclamp the roller clamp of the secondary line then I will hit secondary start note that while the IV piggyback is infusing the hyper alimentation and the vitamin b12 continue to infuse the IV pumps are calibrated so that once the IV piggyback is finished the pump will switch back to the primary volume and rate of the normal saline some institutions have syringe pumps this is a syringe filled with medication that will infuse to the patient the syringe fits into a syringe pump the end of the tubing must be connected to the port that is closest to the patient on a line of compatible fluid this is a central line triple lumen catheter there are also double lumen catheters and single lumen catheters here you see the catheter which looks like one tube or one lumen this is the portion that is in the patient's vessel within this one tube or lumen there are three separate individual tubes or lumens each of the lumens has a separate exit portal this is the proximal line it is an 18 gauge this is the exit portal for the proximal line this is the medial line it is 18 gauge this is the exit portal for the medial line this is the distal line it is a 16 gauge this is the exit portal for the distal line

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