Welcome to nursing school explain and this video on how to set up a secondary or IV piggyback So in this case, I've already set up my primary IV line here And then I have gathered my secondary medication set, which tells me right here Also, it'll show me that this is a secondary set because I have this blue hook in here That allows me to actually piggyback this line to the primary line And then I also have my secondary piggyback right here And as always make sure that you use aseptic technique So wash your hands before you perform any of these skills and put on your gloves So right away because I know this is going to be a secondary line with the hook I always know the secondary or piggyback is going to piggyback onto the primary So what I need to do is open up the set and And then use the hook to start with so I'm going to just open up the package and take out the hook and keep my tubing in The wrapper that way I don't contaminate it by setting it on any kind of contaminated surface So this piggyback tubing is very easy So you will take off the primary bag of the IV pole hook this hook onto the top of the hook and then thread this through the top and actually the other way around because otherwise I won't have a hook and So now the primary bag has been lowered I'm just going to get this other end of the tubing out of the way here So nobody gets confused with the primary and secondary tubing and what they look like So now I have lowered my primary bag and the secondary bag That's also called a piggyback can now go on top here And just remember that the piggyback always sits on top just as if you were given somebody a piggyback ride They are higher than you so the secondary line is up on top here Just like the primary line the secondary the piggyback has two different ports one of them has the rubber stopper where maybe you or the pharmacy has added the medication to this container of whatever IV fluid and Then the blue tap here and think about blue meaning fluid meaning this is where your IV tubing is going to go So since I've already opened up my secondary tubing same as with the primary I take off any paper wrapper Move that to the side and then the first thing I again want one to do is close the clamp That way I'm not losing any medication and the secondary tubing is much shorter than the primary tubing again the Spiker comes with a cap that I need to take off But I also need to remove this cap here so that I have access to My port remember I don't want to touch the spiker once I remove the cap with anything on the outside here I want to make sure I just put it inside the port, so I'll take this off my clamp is closed I will stabilize the port with my non-dominant hand and then use my dominant hand to gently Swivel this in here not touching the spike that's going inside the bag Sometimes it just takes a little push and I again take it until The spike is flush with the port so that none no part of the spiker is Is outside of the bag And now I have a couple of options many times in your IV piggy bank you have a medication added So if you would to prime this by gravity You could theoretically lose some drops and then you would Misgiven the correct dosage because now you have lost some of the medication Which is why we can Prime the secondary line by what's called back priming it and this is a very cool thing that we can do Now that I've set up my primary and my secondary IV piggy back I will need to connect the two Keep in mind that the both clamps are still closed and I use the port that's closest To the back of the primary line and I wipe it vigorously for 10 to 15 seconds And I attach carefully not touching the port My piggy back right here both clamps are still closed so no fluid is going to come Running out of there. So now This line is still empty or full of air What I can do is called back priming. So now I'll take off My piggy back and I will open up The clamp of the piggy back that I've already attached to the primary line Which will draw fluid from the primary line Because down there it's still closed into the piggy back And you can see it'll push the air from the tubing into the bag And I can do this very carefully in the higher I go with the bag The slower the fluid moves the lower I go with the bag and of course the more I open up the clamp The faster it's going to go and then I can slowly See The fluid level coming close here and as I lower it it'll fill up the strip chamber from the bottom And then I'll wait about until it's about halfway full I close my clamp and then put it back up. So now What I have here is in the line Of the secondary IV I pulled fluid from this primary line Into this line and now I can go ahead and start my infusion So whether you use a pump or you use this by gravity Make sure that the bottom clamp as well as the top clamp are open so that you can regulate it because if you keep the Secondary line closed and you either program the pump or you just use it by gravity You will only infuse the primary line as I'm doing right now So nothing is dripping here from the secondary, but if I open up the secondary It'll start pulling you can see the drip here And depending on how far the two are apart or how The machine the pump regulates it you might see dripping from here too But in this case, we're just infusing the secondary line Of course, we have to be careful with the administration rate. So follow the Instructions from the pharmacy on how much or how fast to infuse the secondary line Thank you so much for watching this video on how to back prime a IV piggyback Also, check out the other videos in my medication administration playlist and how to prime a primary line And the same thing could apply to the secondary or piggyback by gravity Which is a lot simpler But you you're at risk of losing that medication like I discussed before. Thanks for watching. See you soon