How to Hang a Piggyback

A "piggyback" is a 50 to 150 cc small bag intravenous solution containing medication, such as an antibiotic, an electrolyte or a steroid. It is usually plugged into a patient's existing IV administration system, hence the name "piggyback."

Double-check the physician's order for the medication against the medication administration record (MAR), and the label on the piggyback IV bag against the patient's armband to confirm administration of the correct medication to the correct patient.

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Confirm the compatibility of the secondary piggyback IV fluid with the primary IV fluid and the compatibility of the secondary piggyback IV medication with the primary IV fluid composition.

Wash and glove hands.

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Open secondary IV administration set kit. Close the clamp on the tubing and spike the piggyback bag.

Hang the piggyback bag higher than the primary IV bag. Squeeze the drip chamber to fill it halfway and open the tubing clamp to prime the secondary IV tubing.

Connect the piggyback tubing to the primary tubing at a Y-port below the level of the primary clamp. For needle-less systems, uncap the port and connect the two tubes. For needle systems, clean the port with an alcohol swab and insert the needle of the secondary system.

Secure connection with tape.

Administer medication at the prescribed rate.

Tips

Depending upon your facility, you may reuse the secondary tubing for additional administrations of the same medication by spiking new piggyback bags as they arrive from the pharmacy. Check the procedure manual for direction.

Warnings

Double-check the patient's allergies before administration of any intravenous medication, particularly antibiotics.