Which sequence correctly describes starting an IV piggyback infusion?

• A. Piggyback is connected below the primary line and the PB clamp remains closed until infusion begins.
• B. Piggyback goes above the primary line, connected above the roller clamp, PB clamp must be completely open, the secondary set is clamped when the infusion is complete, then the primary rate is reset.
• C. The piggyback line runs in parallel and is never clamped.
• D. Begin with the piggyback after the primary infusion finishes.

Answer: (B)

Starting an IV piggyback infusion means delivering a secondary solution into the patient’s main IV line through a Y-site, using gravity to pull the secondary fluid into the line without stopping the primary infusion. The piggyback line is placed higher than the primary line and connected above the roller clamp so that when the secondary flow is allowed, it can enter the main line cleanly and prevent backflow or interference with the primary flow.

The right sequence is to connect the piggyback above the primary line and above the roller clamp, then open the piggyback clamp completely to begin the infusion. When the secondary infusion finishes, clamp the piggyback line to stop it, and then reset the primary rate to continue the main infusion at its intended tempo. This setup ensures the secondary medication or fluid infuses properly while preserving the control of the primary infusion.

Connecting the piggyback below the primary line, or keeping the secondary line unclamped, would risk improper flow or uncontrolled administration. Starting the piggyback only after the primary infusion ends would unnecessarily delay therapy and is not how secondary infusions are normally administered.