Y-ports, also known as piggybacks, provide a second access point in patient IV tubing for additional IV medications to be given. The most common setup is to have maintenance fluids, such as normal saline or Lactated Ringer's, infusing as the primary fluid. Medications such as antibiotics are normally administered through a secondary port or Y-port. Many medications must be given on a pump and cannot be infused through a Y-port connection. Know your facility's procedures concerning proper administration for all IV fluids and medications.
Ensure that the current IV is working properly. For this article, we will assume that the patient has been on IV fluids and just needs piggyback medication given. Wash and dry your hands. Open the package with the secondary tubing. Remove the protective cover and the spike the port of the medication bag. Gently squeeze the medication until the drip chamber is about halfway full.
Allow the medication to flow down the tubing to where the end is sealed off. Using the roller clamp, clamp the tubing so that when the end cap is removed, the medication does not run out on the floor.
Locate the Y-port on the primary tubing. Using an alcohol prep, thoroughly swab the port. Hold the tubing so that the port does not touch anything.
Remove the end cap from the piggyback medication, being careful not to allow the tip to touch any surface. Immediately connect the tip to the Luer lock hub you've just cleaned with alcohol. Tighten the Luer lock into place, being sure that the connection isn't cross-threaded. Do not overtighten, as this can damage the tubing.
Hang the secondary med higher than the primary fluids so that the meds infuse first. Adjust the roller clamp on the secondary tubing to obtain the proper drip rate.
When the med has finished infusing, the primary fluid will begin to infuse. At this point you can clamp off the secondary med and hang it below the primary fluid. Ensure that the primary fluid is dripping at the proper rate. Chart the medication given in the med area of the patient's chart. If the patient is on strict I's and O's, record the total fluid infused from the secondary med in the I's and O's area of the chart.
Never use a Y-port to administer meds that require an IV pump for safe delivery. Assess the patient's IV site at least once per shift to ensure proper functioning and that there is no pain, infiltration or leaking.
Roma Lightsey has written for "Grit," "Arthritis Today," and "The Clinical Advisor," a journal for nurse practitioners. Lightsey holds a Bachelor of Arts in communications, a Bachelor of Science in nursing, and a Masters of Science in nursing. She currently teaches nursing and works for a medical device company when not busy writing.