An IV piggyback is a very small bag of IV fluids that is piggybacked or attached into an existing IV line. In most cases, the piggyback medication is an antibiotic, although steroids or minerals may also be administered this way. These small IV bags containing 50 to 150 cc (or ml) of fluid are attached to a length of clear, plastic intravenous tubing known as secondary tubing to differentiate it from the primary tubing of the established IV line. The terminal end of the secondary tubing is then attached to the primary IV tubing at a port in close proximity to the IV cannula insertion site. Medical advantages of using an IV piggyback include nursing care and maintenance of only one IV site as opposed to two or more and decreased risk of infection or complication with a single, as opposed to multiple, intravenous sites.
IV insertion sites, where the IV catheter pierces the skin to enter a vein, require frequent nursing assessments and evaluations for patency, leakage into the tissues and infection. These evaluations are conducted prior to the administration of any new medication or IV bag, as part of a patient’s physical evaluation each nursing shift, and whenever an IV pump alarm sounds. Depending upon the facility, IV catheter sites are only allowed to remain for a maximum number of days before a new site is established in order to decrease the chance of infection. Thus, the use of an piggybacked IV may decrease the nursing workload by reducing the number of IV sites to be evaluated multiple times a day or to be restarted when the cannula site times out.
Another medical advantage to using IV piggyback medication administration is the decreased chance of infection or complications. Every interruption in skin integrity allowed by an IV catheter is a potential route for pathogens and subsequent infection. Hooking an IV piggyback into an existing primary IV line allows for only one IV site at a time, as opposed to two separate IV catheters doubling the chance of untoward reactions.
Using an IV piggyback can also increase patient comfort, or at least decrease the number of times an IV catheter needs to be inserted. This can be particularly important in individuals with poorly accessible veins who often require multiple attempts to establish a patent IV line. This is often the case in the elderly, the obese, those undergoing chemotherapy, and individuals with a history of IV drug abuse.