Pharmacy Pearl 31 January 2001

The nurse intern catches you on the floor and asks about infusing a patient's antibiotics. The elderly patient is a "hard stick" and they only have one line. All intravenous preps are running through the line. Currently in that line, the patient is receiving a unit of packed red blood cells (PRBCs) and they won't be finished for another hour or two. The nurse intern asks if she can infuse the antibiotic into the same line as the blood. She says the ABX will be going directly into the blood in the vein anyway, so why not?

What's your advice? Run it with the blood or not?

SELECT here for discussion

NEVER run anything in the same line as blood or blood products. The reasons are:

1) If a patient has a reaction, focal or systemic, you won't know if it's the ABX or the blood.

2) If the ABX is mixed with Dextrose 5% in water, you could have rouleau formation in the infusing blood. Use ONLY 0.9% Sodium Chloride to infuse blood.

3) Sterility concerns mat arise. the less amount of times the line is entered, the less the chance for contamination.

This Pearl is meant for academic and educational purposes only. This Pearl is meant to raise important points regarding the safe and cost-effective pharmacotherapy of patients. It is not meant to be the definitive reference for the treatment or prophylaxis of various diseases. Although every effort is taken to ensure this Pearl is correct and factual, errors may occur. The Pharmacoeconomic Center assumes no liability for incorrect information or harm that may occur from the use of the information included in this Pearl.