# What is an example of a math problem involving a bolus for dehydrated ped pts

1. criteria: 20 m|/kg over 20-30 minutes for a dehydrated pt. is a bolus an ivp?

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4. It's been more than 20 years since I've done peds but if it's over 20-30 minutes I wouldn't push it. In the old days we had syringe pumps for that when it was not enough to put in at least a 50 ml bag and hang on a pump.
5. Quote from j-swish
criteria: 20 m|/kg over 20-30 minutes for a dehydrated pt. is a bolus an ivp?

no. a bolus is a bolus, you don't push it, it's run on a pump. we almost always run boluses over an hour in pediatrics. 10-20 ml/kg is standard for a bolus in pediatrics. 40 ml/kg is the max at my institution.
6. Just want to know what kind of math question is shown in regards to a fluid bolus for a pt with severe dehydration. I'm just given that much info to know yet I have not seen an example of such a question. I'm also given that criteria as seen from above.
7. Like, your patient is 15 kg and needs a 20ml/kg bolus, how much is the total bolus and what do you set the pump for to have it run in 20 minutes? Is that what you mean by an example?
8. That totally makes sense. In that case, the total bolus is 300 mL? And the pump should be set to: 300mL/.33 hr?
9. Quote from J-Swish
That totally makes sense. In that case, the total bolus is 300 mL? And the pump should be set to: 300mL/.33 hr?
No. If a 15 kg child was to get a 20 mL/kg bolus, they would need to receive 300 mL of Normal Saline. To run 300 mL over 20 minute, you set the pump to run 900 mL/hr with a VTBI (volume to be infused) of 300. Pump rates are set as mL/hr. You were on the right track, but what they'd be looking for is mL/hr.

Syringe pumps will allow you to program volume/time (300 mL/20 min) but you couldn't run 300 mL on a syringe pump and in the end, it would still give you the rate of 900 mL/hr and you would need to know that that is correct.
10. In regard to fluid boluses in general, how fast you give the bolus depends on the clinical situation.

If you have a patient that is showing signs of shock- hypovolemic, septic, obstructive- then you're going to give fluid boluses as quickly as you can. Sometimes you are pushing the bolus with a syringe by using a stock cock- drawing it off the bag and pushing it into the patient. You can give 3-5 boluses of 20cc/kg in the treatment of shock.

The exception is cardiogenic shock, or any time you have a patient with impaired cardiac function. You need to be very careful giving a bolus with these patients because you could cause pulmonary congestion.

If you're giving a bolus for rehydration of mild to moderate dehydration, you can give the bolus more slowly, over half an hour or an hour.