What is an IV Piggyback?

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  • Originally Written By: Lucinda Reynolds
  • Revised By: A. Joseph
  • Edited By: C. Wilborn
  • Last Modified Date: 02 February 2019
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An intravenous (IV) piggyback is a way to administer medication through an intravenous tube that is inserted into a patient's vein. This can be an antibiotic or another type of medication that needs to be diluted and administered slowly. The medication in an IV piggyback is mixed in a small amount of compatible fluid, such as normal saline or dextrose with saline.

Gravity Drip

The IV piggyback is aptly named because the medication is given on top of the main intravenous solution. This allows for the intermittent infusion of medications at specific times. The piggyback infusion usually is hung higher than the main IV solution and is connected to a port in the main tubing. Hanging the IV piggyback higher than the main solution causes it to infuse faster than the main solution.

IV Pump

If an IV pump is used rather than allowing gravity to cause the IV fluid to drip, then the nurse can electronically program the pump. The pump can control the flow of each medication or solution and can even stop the main IV infusion and allow the secondary medication to infuse. After the IV piggyback is finished, the main fluids will begin to infuse once again. When an IV pump is used, the height at which each of the bags is hung does not matter.


Saline Lock

A piggyback infusion also can be administered without a main IV fluid infusing. A patient can have IV access called a saline lock, or heparin lock. A saline lock is an intravenous catheter that is inserted into a vein and then capped, which allows periodic access to the vein for medication administration. An IV piggyback can be attached to the saline lock every few hours and then disconnected after the medication has infused.

Medication Compatibility

The medications in the piggyback infusion might not be compatible with other IV piggybacks. If two incompatible medications mix in the same line, it could form a precipitate or crystallize in the tubing. Therefore, it is important that the intravenous tubing be flushed between IV piggyback administrations. This flush can be performed by lowering the secondary tubing to allow the main intravenous solution to back up into the secondary line to flush it.

Some hospital policies require a separate IV piggyback line for each medication. When there is a dedicated line for each medicine, there is little risk for incompatible medications mixing. This can become a challenge if a patient is on several intravenous piggybacks, because of the number of IV lines that will be hanging from the pole.

Saline Flush

If the patient does not have a main intravenous fluid infusing, the saline lock should be flushed with normal saline before and after the administration of an intravenous piggyback. This will clear any remaining medication left behind in the saline lock.


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Discuss this Article

Post 5

Thank you. This is very clear and easy to understand. I wish they would teach this way at school.

Post 4

IV piggybacking is one of the most wonderful medical inventions ever made -- you don't really think about it, but being able to have an open area or line ready to go for medication, doctors and nurses can not only administer the medication more efficiently, but they can also do so without having to stick the patient a bunch of times.

Of course, learning how to hang an IV piggyback takes a little time, but in the end it saves so much time for nurses in the end that it is very much worth it.

And although there is the concern of IV compatibility, truth be told, nursing of IV patients is very high priority, and mistakes, though terrible when they do happen, just don't happen all that often.

Post 3

Frankly, the whole idea of an IV piggyback scares the heck out of me. Or rather, the idea of someone forgetting to check for IV compatibility when hanging my IV piggyback.

I know its easy to complain about doctors and nurses making mistakes in hospitals, but unfortunately, there really are a lot of mistakes and mishaps that take place in hospitals, making it very dangerous for patients and doctors alike.

I'm not saying that it's always the doctors and nurses fault either -- they're often so overworked and busy that they simply don't have the time to care for patients properly.

However, no matter who's fault it is, it's still scary. I mean, I'm no chemistry person, but

the thought of medicines and chemicals mixing together before they go into my bloodstream is enough to make me cringe.

So I think I'll just try to stay as healthy as possible, just to minimize the chances of something like that ever happening.

Post 2

Nicely done -- I find that so often sites that give the definition of medical terms are just insufferably dense and impossible to understand -- I'm so glad that you wrote this article in the way that you did, that is to say, in a detailed yet succinct manner.

My cousin is getting her IV certification, so I often end up helping her study for her quizzes and tests, which means that more often than not I end up googling things like "IV piggyback definition" and then having to crawl through a bunch of medical jargon just to get a clear answer.

Well, not here. You definitely answered the question, and you didn't make me work for it -- but still gave me a good understanding.

Thanks, wisegeek.

Post 1

This article was so helpful. Thank you. I was curious about why all piggybacks aren't started right after the one before it has infused, and I didn't realize that some hospitals had policies against it. I didn't realized the reasoning behind lowering the piggyback down, but I realize now that the primary fluid will flow back into the piggyback line. Thanks again.

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