Lecture Notes: Hanging an IV Piggyback and Performing an IV Push

Introduction

Presenter: Ellis from Level Up RN
Topics Covered:
- How to hang an IV piggyback (secondary line)
- How to perform an IV push (bolus medication)
Reference: Clinical Nursing Skills Cards from Level Up RN

Saline Flush:
- Eject air from the saline flush before use to avoid air bubbles and ease administration.
- Pressure: Air creates pressure, making it hard to start if not ejected.
Saline Lock:
- Clamping: Ensure clamp is engaged when not in use.
- Student Mistake: Difficulty pushing medication can occur if clamp is engaged.

Preparation Steps:
- Perform hand hygiene.
- Wear gloves.
- Draw up the medication.
Disinfection:
- Use medicated/disinfectant caps or a disinfectant wipe if caps are not used.
Flushing Saline Lock:
- Use 3-5 mL of normal saline to check the patency of the IV site.
- Flushing helps ensure saline is in the vein and not surrounding tissue.
Administering Medication:
- Connect medication syringe and push at recommended rate.
- Verify rate from drug textbook/online/pharmacy.
Final Flush:
- Flush again with 3-5 mL of normal saline at the same rate.
Post-Administration:
- Lock the saline lock.
- Reapply cap if using disinfectant caps.

Preparation Steps:
- Verify compatibility between the primary line fluid and push medication.
- Pause the pump, clamp or fold tubing to prevent backflow.
Flushing Line:
- Use a 10 mL syringe of normal saline to clear the primary line.
Administering Medication:
- Attach medication syringe and push at recommended rate.
- Use drug book/pharmacy for rate guidance.
Final Flush:
- Use normal saline to flush the line at the same rate.
- Prevents drug interaction with primary line fluid.
Post-Administration:
- Reapply disinfectant cap if applicable.
- Unclamp/unkink tubing and restart pump.

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