What is the recommendation for administration of infusion medications using a 50 ml or even a 100 mL bag of diluent when the administration sets have 16 – 20cc priming volume? If you change when the medication bag is empty and there is still some medication in the drip chamber, using a 50 mL bag with priming volume of the administration set at 17cc, the patient is not getting 35% of their medication. In a 100 mL bag, the patient would not be getting 17 mL of the medication. Although on intermittent doses during the day, you would only lose this amount of medication once, what happens when it is a daily dose?
What drug(s) are you asking about? This was never a problem until we started using all electronic infusion pumps for alll patients. An infusion pump set does hold a significant amount of the dose. I can think of 2 options.
1. infusing intermittent drugs like antibiotics by gravity. Problem is that nurses no longer know how to count drops and manually regulate this infusion.
2. Piggyback these intermittent drugs into a carrier of normal saline and allow this fluid to flush out the residual drug from the set. Problem here is the shortage of saline solution, so you may have to use other fluids. And this fluid would require either a patient specific order or address this by a protocol to cover the infusion of this additional fluid.
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