Hospira Plum pump users; when you are administering an intermittent medication/IVPB and do NOT have a primary infusion do you; please choose and respond;
Use a flush bag as a primary and run the IVPB in as a secondary using secondary tubing? If yes, how often do you change this flush bag, and what size NS solution flush bag do you use? Do you disconnect and flush with NS syringe after infusion? OR
Use primary tubing to run in the IVPB? Then Disconnect and flush with NS syringe OR
Use straight tubing and not use the Plum pump/run in per gravity? OR
Other??? Please explain your practice, thank you.
I have always practice and still teach to practice infusing only intermittent medications by gravity as I see no need for any brand of electronic pump. When the patient has been taken off of continuous infusions, they are usually relatively stable, and eating and drinking sufficiently. Therefore fluid and electrolyte balance is not an issue. The goal has changed to infusing the medications in a timely manner. This can be done with gravity only. 30 to 60 minutes of infusion time for 50 to 100 mL of fluid can easily be regulated by gravity and the therapy does not require the level of control provided by an electronic pump. Additionally, some ABX are potent vesicants (e.g. vancomycin). If this is being forced in with a pump, the risk of extravasation injury goes up.
If you do decide to use a pump, the piggyback set must remain connected to your primary set in the same manner that this remains connected when infusing continuous fluids - see standard on administration sets from INS. You are still disconnecting and reconnecting the primary set with each dose, so this means the entire set-up should be changed every 24 hours. This only raises the cost of therapy without providing much additional benefit, in my opinion. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861