ER nurses are notorious for giving fluids wide open or on mini med tubing. I thought it would be cool to compile a list of the meds we use a pump for our categories.
Ns on a young generally healthy person
NS wide open for emergent situations
Emergency blood admin (life or death)
Any fluids for pt at risk for fluid overload chf, dialysis pts, elderly)
Strict I/o pt (pre op, etc)
Generally anyone I anticipate going to ICU
Narcotic drips (duh)
What do you consider to be a drug or antibiotic that MUST be on a pump?
Feb 19, '14
Basically any bolus of fluid that is flowing well on its own, I go with no pump. I will also "free flow" stuff that does not have a specific rate/infusion time specified. For example, benadryl or decadron (I've learned by bad experience that those shouldn't be pushed...or not pushed to quickly--it's just easier to put them in a minibag and piggyback them).
Our policy specifies the infusion time for ABX (for instance, 30 min. for 4.5 g of zosyn--although I might free flow this one if we we short on pumps, which occurs from time to time; 2 hours for a 1 g of vanco, etc.) so I put them on a pump. And then of course there is the stuff that has to be, no exceptions, on a pump--KCl, NTG, dilt, heparin, etc.
Feb 19, '14
Main Job, we have one or more pumps in every room, I put everything on a pump unless it needs to be put in via pressure bag, i.e. blood/fluids that need a pressure bag to get in now.
PRN job, only a couple of pumps in the facility, pumps are used sparingly only when counting drips isn't sufficient or when every time I check on the pt the fluids have stopped because they are bending their arm, etc.
Personally, in ideal situation I'd go with the abundance of pumps, I find it makes the fluid administration more accurate and reliable.