Protocols for concomitant infusions in the same IV line

What is the protocol for using the same intravenous line for concomitant infusions of IV chemotherapy drugs with other IV medications? Our agency policy is that chemotherapy is infused alone as a secondary line (Y-ed in with sodium chloride primary line) and no other agents used through that line. I am unable to find guidelines in regard to why the same line cannot be used when compatible drugs are being infused. —Titza Suvalcu, RN, MSN, OCN

Y-ports, also known as piggybacks, provide a second access point in intravenous tubing for additional IV medications, such as administering chemotherapeutic agents concurrently with supportive care fluids and/or medications. The most common setup is to have maintenance fluids, such as normal saline or Lactated Ringer’s, infusing as the primary fluid. Chemotherapy is 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. One should become familiar with the institution’s procedures concerning proper administration for all IV fluids and chemotherapy medications. This subject is so exhaustive that a simple answer would not do it justice. A good reference article is “Chemotherapy Administration Sequence: A Review of the Literature and Creation of a Sequencing Chart” (J Hematol Oncol Pharm. 2011;1(1):17-25). —Donald R. Fleming, MD