Currently working in Canada(from scotland originally) and had never heard of this phrase (TKVO)till I came here.
Can anyone tell me where it all started. As far as I can tell people here are only beginning to waken up to what is best practice. Nursing research?what's that!!
I have had many heated discussions with nurses who are convinced that you have to have a flow of at least 30ml/hr regardless of the med(heparin included) and despite running the med through a pump. "ridiculous" CAN ANYONE CONVINCE ME ABOUT TKVO?
in need of enlightenment
Jul 30, '02
Prior to the introduction of IV contol devices, we had to calculate drip factors and manually set them using the roller clamp. At that time 20 cc/hr was considered kvo rate. (much easier to calculate) At the hospital I work at, all fluids are on pumps and these devices provide constant pressure that permits fluid rates as low as 5cc/hr without problems. I'm not sure if this is the answer you were looking for.
Aug 1, '02
Try to remember there are many types of nursing and experiences. I haven't experienced the types of pumps that provide the constant pressure that pauls-gal mentions until I started homecare. homecare pumps we kvo with as little as .2cc hr. with anywhere from q day to tid administration of the medication. This has been in the states for many years and we are not just beginning to waken up to it as you say. The nurses you are experiencing just haven't experienced it yet.
Aug 1, '02
KVO is usually set by the facility and may depend on the IV access. We us a KVO of 10,20, or 40 depending which type of access. BTW- some hospitals sill us the good old count the gtt method. I just changed jobs and couldn't believe that at the new hospital there are pumps all over. I asked my preciptor if the nurses REALLY didn't have to do any caculations and she looked at me as if I had just grown a second head. At my previous placement (as in 2 months ago) the nurses had to caculate drip rates and count gtt unless it was insulin or cardiazam- these went on a pump. I acutally got quite good at calculating gtt rates at the bedside without a caculator! It's one of the skills I'm most proud of.
Aug 6, '02
Thanks very much for your comments. I am still a little confused about TKVO.
Does anyone know how much per hour or pressure per iv cannula is needed to KVO?
Has anyone ever done any research into it?
As well as IV's running at rates TKVO,we also have saline locks which are flushed q12h with 3cc N/S and this seems enough to keep the cannula patent if this is so then why do we need an IV running at a variable rate(depending on the facility) I would be extremely interested in finding any study that supports running an IV TKVO Vs a saline lock Vs what is the best rate
I do apologise if I offended anyone with my "waken up to best practice" but I justify it by the fact that no-one can give me the rationale for running an IV 0.2cc/hr or 20-30-40 or 50cc/hr. I guess what I'm saying is that depending on where you work will depend on your practice regardless of the rationale.
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