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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
Manual: Hospital and Hospital Clinics
Chapter: Medication Management MM
First published date: May 20, 2019 This Standards FAQ was first published on this date.
This page was last updated on October 19, 2021

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