News | August 16, 1999

I.V. Q & A: Priming/Flushing the Secondary Set

Editor's Note: Have questions about infusion therapy? I.V. Q and A is the place to look for answers. Check back weekly for a new question related to the placement, use, and maintenance of I.V.s.

I am a nurse at an Atlanta hospital, and we are reviewing the implementation of a policy using back priming/flushing the secondary set with the primary fluid. Some clinicians are questioning the capability of drugs, primarily antibiotics, due to the possibility of drug leaching into IV tubing and subsequent untoward reactions. We will be checking with our PharmDs, but I want to know about this practice in other facilities. Do you have any information about this practice?

This is a fairly popular infusion system and is manufactured by several companies. Compatibility is a concern secondary to the additives, pH, etc. of the main carrier/infusate and the medication to be admixed then administered. In-line filtration systems in the administration set must also be factored in order to prevent unmixed medication particles from entering the vascular system. I suggest you consult, as you have already indicated, with your pharmacy as to what IV medications would be commonly involved in this system, as well as consulting extensively with your selected manufacturer as to cost/benefit for your organization.

Reprinted with permission from the INS Newsline, Intravenous Nurses Society, Cambridge, MA; These questions come from I.V. clinicians and are answered by Debbie Benvenuto, CRNI, INS Nurse Educator/IV Therapy and coordinator of the INS National IV Nursing Network.

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