Medication Preparation - Spiking Intravenous (IV) Bags in Advance of Administration

Once an IV bag of fluid is spiked with the IV tubing, how soon must this infusion be initiated ?

Any examples are for illustrative purposes only.

The infusion must be started within 1 hour of spiking the bag unless the bag was spiked in an ISO 5 environment.
  • When a bag is spiked and the infusion is immediately begun, the spiking of the bag is considered part of the administration process.
  • If the bag is spiked and then stored for later use, it is considered to be a part of preparation.  
  • If the bag is spiked in an ISO 5 environment, then beyond use dating would be consistent with those listed in the USP 797 Chapter. 

Organization policies, procedures, staff education/competencies, etc.,  should also take into account:
  • Product and device manufacturer's instructions for use
  • Evidence-based guidelines for safe administration practices
  • Applicable law and regulation
Last updated on March 03, 2021
Manual: Ambulatory
Chapter: Medication Management MM

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