Secondary Medication Set (Nursing Skills)

Nurses routinely give medications to patients through a secondary medication IV set also known as a secondary IV Piggy Back or secondary IV set up.
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This video is about Secondary Line IV Medication Administration using an Alaris pump. Review the equipment needed to correctly prepare and label your medication bag and the process to reconstitute according to a parenteral manual.
Learn how to back prime your line to ensure all the medication is available to your patient (as opposed to using the medication to prime the line - we always lose some medication when we do it this way).
Labeling your lines is just as important as mixing your medication. It is a way to communicate to your team when the line expires and will require changing (per protocol). An unlabelled line is an expired line.
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[@amieagain2]

Online nursing school is hard. Only having a voiceover on a powerpoint explaining piggy backs is even harder. Thank you for showing what was voiced-over during our lecture!!

[@NurseMinder]

Ah! 😊. Thanks for that

[@israelo.3911]

Omg you are a life saver !!!!! Why did I not find these videos sooner !!! Thank you sooo much ! Wish my school had pre recorded videos.

[@NurseMinder]

So happy this helped :)

[@laurabridges9115]

Literally want to hug you. Steps are so simple I've memorised them ready for my clinical lab tomorrow

[@NurseMinder]

Awesome! I hope that lab went as smooth as you hoped!

[@mariecarmenmailvaganam7316]

Hi there, great video! My onlu suggestion would be to make sure that all the clamps on the IV lines are open before pushing on the "Start" button of the pump. :)

[@roseteye6457]

Thank you Tammy we are learning a lot from your channel. Keep doing the good job.

[@NurseMinder]

Thank you Rose for sharing your thoughts

[@juliemanto3634]

Thank you so much, you go step by step and explain the instructions very clearly. It has helped me a great deal. Thank you again for doing these videos.

[@NurseMinder]

😊

[@kamaljamal890]

you don't even know me, but i'm going to tell you something, you are an extraordinary person 🌺 thank you so much for every single video you've done

[@NurseMinder]

Hey Kamal! Thank you so much. That is a very special message to receive 💕

[@viviane.4455]

Thankyou for the video on setting up the secondary line. Very Straightforward. Thumbs up.

[@NurseMinder]

Thank you for letting me know it was helpful ☺️

[@D3ltaFreedom]

Thank you. Great tutorial!

[@NurseMinder]

Thanks for the feedback 😊

[@ncp3077]

Thank you very much

[@tamikajoy7259]

This is so helpful. Thankyou so much.

[@tamikajoy7259]

I have a clinical exam tomorrow and this was awesome. I had no idea that is was that easy.

[@NurseMinder]

Oh my goodness! So happy it was helpful ❤️ the whole reason I teach online is to give students access to content when they need it, where they need it. This makes me happy

[@emryszhan685]

You have all videos that i need 🥰🥰🥰

[@NurseMinder]

Yeah!!! If you have any ideas, send them along. I don’t always have the equipment but you never know!

[@emryszhan685]

I want to explore the intensive care unit equipment. if there is a chance you can have a vid of each of them.

[@NurseMinder]

No. The specialty equipment is not something I have access to right now.

[@Anne-tp7ny]

Thank you

[@NurseMinder]

You’re welcome 😊

[@dawansiewdorsyiemlieh4343]

I learn a lot in this video

[@NurseMinder]

Makes my heart happy

[@ediannareyesovalle9636]

So helpfullll

[@NurseMinder]

Awesome!!!

[@SaNa-hv6uq]

Hello Thank you so much for your helpful videos. Could you make a video about the required nursing skills after the blood transfusion reaction ( for example what to do with the iv line step by step if the transfusion reaction happens)?

[@NurseMinder]

Great idea. Here is a quick list. Stop transfusion. Initiate NS at the site closest to the patient. VS. Call the doc :). Save the line in case it is restarted or needs to be sent back to blood bank

[@SaNa-hv6uq]

@@NurseMinder thank you ❤️

[@Xamanda3lynnX]

Hello! Quick question. When you hang a very small IVPB (ex 50ml bag), how do you ensure the patient receives all of the medication including what’s in the secondary tubing??

[@NurseMinder]

Use a primary line to flush the medication, program a flush of 30 ml

[@CYTO365]

NurseMinder I would like to clarify what I believe Amanda meant. There is a residual volume in the secondary line of about 2 inches. Sometimes I have seen a technique to lower the small IVPB and back flush from your primary bag and then re position your small IVPB again above the primary bag to run the remaining. Is this what you would recommend?

[@ncp3077]

Wonderful content new subbie

[@NurseMinder]

❤️

[@blushy3001]

May 29, 2016

[@caitlynnichols3632]

When do you pause the primary infusion?

[@NurseMinder]

There are many reasons - and it depends on the infusion - some are so critical that I would not pause - perhaps the patient goes off the unit for a test, or to the shower - pausing an infusion may be ok in these circumstances

[@NurseMinder]

I also wonder if you are asking “do you pause the primary to let the secondary line infuse” / the secondary line will run and automatically pause the primary as the secondary bag will be higher - and the gravity pull stronger

[@chanthasem8152]

Good morning

[@NurseMinder]

Good morning!

[@johannesberg8649]

Please explain every little thing you are doing. Like when you had a 250 mL bag but only programmed 200 because you "like to give yourself a little time;" a little time for what? Please explain little things like this so we all know how to think like nurses.

[@NurseMinder]

With a 250 ml bag, we have used 25 to 30 ml to prime the IV line. I never program a primary line for the full amount of an IV bag for that reason. It will run dry and end up with air in the line. Second thing to remember is when programming it for 200 ml, I am giving myself a buffer. When it beeps that the fluid has finished, there will be another 20 ml in the bag. I can program the IV to continue running for 20 ml while it gives me time to get a new bag. Hope that helps

[@johannesberg8649]

@@NurseMinder Yes, it does! Thank you, and include good tips like this into your videos!

[@ncp3077]

@@NurseMinder This makes sense but I thought you said the order was for 100 mls? Please explain.

[@sharonmathews582]

Mostly it was very good, but there were a few spots where it went a little fast or the camera wasn't in the best place to see clearly.

[@NurseMinder]

Thank you for the feedback

[@ianshelton6662]

Why do you have such a small primary? In an adult you'd want to have a 500cc at least, preferably 1 litre bag.

[@NurseMinder]

It will depend on the needs. The primary bag, once spiked, has an expiration. If it is only used for med admin, a 500 or 1000 ml bag is excessive.

[@ianshelton6662]

@@NurseMinder I thought primary was maintenance fluids and your secondary was your med administration, at least that's how it is in dental surgery.

[@NurseMinder]

Yes. If you have a maintenance fluid rate, ie 100 ml/hr, then it makes sense. If you are only needing the primary bag to flush your secondary med (and need 30 ml), then a smaller bag will do

[@ianshelton6662]

@@NurseMinder Good to know. Thanks for clearing that up, I just know that every patient having IV sedation in a Dental office has a primary maintenance rate. (usually 500cc of NS, D5, or LR) I really find your nursing videos helpful! They could be used to train dentists on IV concepts for anaesthesia and sedation licensure.

[@NurseMinder]

Thank you for the feedback :)

[@maviswilliams9848]

U need gloves, instructor.

[@NurseMinder]

Mavis Williams Hi Mavis. The use of gloves is important to protect us from coming into contact with bodily fluids. If you can share with me where you feel gloves are needed then I can provide you with a better response :)

[@angelenepetitjeune572]

Any contaminants can go inside the bag therefore entering the pt's bloodstream via intravenous fluids. I think the use of gloves would minimize the chance of that happening. In school we were taught to wash hands and use gloves. Even during med pass.

[@Niight0wl]

@@angelenepetitjeune572 Maintaining aseptic technique would prevent contamination of the IV meds & port so gloves aren't necessary.