>> Kathie Kushto-Reese: I'm Katherine Kushto-Reese.

>> Shari Lynn: And I'm Shari Lynn. Today is enteral parenteral secondary iv infusion.

>> Kathie Kushto-Reese: Wipe. Check orders. Open piggyback solution, also known as secondary infusion. Check bag for turbidity, cloudiness, expiration date and medication dose. Open secondary set infusion. Close the roller clamp. Spike the piggyback, being careful not to contaminate spike with a twisting motion. Invert bag. Squeeze the drip chamber and prime the line, slowly, being careful not to waste any IV fluid. Wipe the port above the pump on the tubing. And attach secondary set to the primary line. Lower the primary bag, using the hanger in the piggyback secondary set. Select channel A or B on the pump. Select secondary infusion. And set the rate and the volume to be infused for the piggyback medication. Open the clamp on the secondary set. And press start. Observe the drips in the chamber of the secondary set to assure that it is running. The primary line infusion should not be dripping. Wash hands and document. An alternative way to prime the secondary or piggyback tubing is called back priming. Wipe. Lower the piggyback or secondary tubing to a level below the primary bag. Open the roller clamp of the secondary tubing and allow the fluid to back prime from the primary container in to the secondary tubing. Close the roller clamp once the secondary is primed to a desired level in the drip chamber. Change the IV bag to the new primary bag. Raise the secondary container and hang above the primary. Set the parameters on the pump for rate and volume to be infused. Open the secondary roller clamp and press start. Ensure that the secondary set is dripping. Wash hands and document.