How to Not Die in the Hospital - page 3

Tragically, many people die from medical errors every year in hospitals. It’s hard to know how many. “Medical error”is never listed as a cause of death on death certificates. But according to... Read More

  1. by   KatieMI
    Quote from Holt147
    Well, the B. Brauns (pre-programmed) volume to be infused (VTBI) is programmed to give exactly what is stated to be in the medication bag. B. Braun does not clear the IV tubing, does not allow for bag overfill, nor does it ask if you have extension tubing on this patient!
    If its new version flushes the IV tubing at 10 CCs per hour, it will take about 2 and a half hours to clear the antibiotic out of the IV tubing. Problems:
    A: That means half of the 50 CC antibiotic dose is given too slowly to create the MDs desired peak.
    B. You or a colleague are likely to disconnect the TKO patient for Physical Therapy or some test.

    I don't understand where the 100 or 240 extra CCs you mentions comes from. If the patients total volume intake is an issue, we RNs need to ask the MD or Pharmacist if the antibiotic itself can be mixed in less liquid, but we still need to get all of the IV tubing that it goes through flushed.
    We RNs can stamp out this type of IV medication error.
    It does allow for manual refill (and therefore flush) of the secondary bag from primary line, which is precisely what you want, and also for programming those 20 to 30 cc of refill to be infused as 1200 cc/h (2 to 3 min) to "empty piggyback". Find someone who works with this device, we'll show you some tricks if we got time for it.
    The volume of line for this pump is 12 cc, so 20 will flush it pretty good.
    If primary is left to run KVO 10 cc/h, then even 10 hours out of 24 will give those 100 cc/24 h.
    Anyway, this is surely a subject for entirely different topic.
  2. by   Holt147
    I've used the Braun for years thank-you, though for completeness I viewed the video.
    As expected, the commentator programmed a 50 CC antibiotic to run for...guess what...50 CCs.
    Half of the medication is still in the IV tubing. A few CCs are still in the bag, so it's obvious that the tubing is full of antibiotic.
    Our B. Braun tubing package says 23 CCs for the mainline IV tubing (most of which is full of antibiotic) and 8.8 CCs for the secondary IV tubing (all of which is full of antibiotic). Any extension set or central line IV tubing is of course full of antibiotic.
    I'll never program the last 25 CCs (plus) of an antibiotic to run in at 1200 CCs per hour, when its rate is supposed to be 100 per hour.
    Nor will I ever program a non-central line for 1200 CCs per hour.