How to figure out VTBI?!!!

[ital91]

I know there are a lot of posts on this, but I still don't get it.

Let's say I have an order for 100ml NS in 8 hrs. That's 800ml. If you're using a 1000ml bag, you would set the VTBI to 750ml not 1000ml, correct?

Thanks all for the clarification.

[KelRN215, BSN, RN]

100 mL NS IN 8 hours is 100 mL in 8 hrs or 12.5 mL/hr. You don't say where you work, but this is about maintenance for a 3.1 kg baby so not an unheard of rate.

But, based on the rest of your OP, I assume you mean 100 mL/hr x 8 hrs. In that case, your Volume to be infused is 800 mL. If you want to infuse 800 mL, why would you set your VTBI at 750? The only rationale for underprogramming the VTBI is to prevent air from getting in the line. But if you have a 1L bag, you have plenty of overfill.

[Boomer MS, RN]

If I understand your question, 100ml an hour over 8 hours, VTBI (volume to be infused) is what is ordered, and you got that, 800ml. Why would you think you would set the pump to 750 for VTBI if the order is for 800ml? If you are a student and have never seen a pump, I can see why this can be more confusing for you. But it is simple math.

If the question is 100ml in (over) 8 eight hours, the answer is different. Again, simple math.

[iluvivt, BSN, RN]

If you just want to administer 800 ml then set the volume to be infused at 800 ml. Since this this an order from a licensed practitioner it must be followed exactly as ordered and 750 ml is not 800.I think you may getting confused when you have an order for continuous IV fluids which is a more common order.Since IV fluids commonly come in bags of 1000 ml and 500 ml this fact must be considered when setting up volumes on volumetric pumps.Let me give a more common order.You have to administer D5 and 1/2 NS at 125 ml per hour.Get your 1000 ml IV bag and inspect it.Now set up the pump.IV bags often have a bit of overfill but if you don't want your bag to run bone dry and trap pesky air bubbles that are a pain to clear set your volume a tad under the 1000 ml .Set it at what you like: It can be 990...It can be 950...It can be 970...it can be 960.Once that is done set up your rate at 125 ccs an hour, When your IV pump has administered the volume you set as the VTBI it will alarm and you will go in and change the bag and reset the VTBI to 950...990...980...or whatever.

[ital91]

From what I've learned you always set the VTBI less than because you want it to alert you to change the bag..

[ital91]

and yes, I'm a student. IV pumps confuse me..

[Boomer MS, RN]

ital91 said:

From what I've learned you always set the VTBI less than because you want it to alert you to change the bag..

Yes, setting the VTBI for less than what is ordered is wise, for the reasons Iluvivt stated. I was confused by your question. Everybody gets confused. But you "got it". Pumps will become second nature to you with experience and time.

[Rose_Queen, BSN, MSN, RN]

ital91 said:

From what I've learned you always set the VTBI less than because you want it to alert you to change the bag..

Except that if you are to infuse 800mL and you have a 1L bag, you've already got 200mL extra, and you won't be changing the bag. Why make more work for yourself?

[ital91]

Now if I had a secondary IV bag, what would the VTBI be set to? the same as the primary?

[KelRN215, BSN, RN]

ital91 said:

From what I've learned you always set the VTBI less than because you want it to alert you to change the bag..

If you're only infusing 800 mL and your bag is 1000 mL, you won't be changing the bag.

[KelRN215, BSN, RN]

ital91 said:

Now if I had a secondary IV bag, what would the VTBI be set to? the same as the primary?

It would be set to the volume you want the secondary bag to infuse. Do you understand what VTBI means? Volume To Be Infused. You are telling the pump how much volume to infuse.

If you are infusing, say, Vanco in a 250 mL bag on the secondary, why would you set the VTBI to 800? You only want 250 mL to infuse on the secondary.

[traumaRUs, MSN, APRN]

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