I have a quick question when an order for a primary solution lets say NS that is ordered to be infused at 100ml/hr and the volume is 500 ml. When your setting up the infusion pump do you set it up exactly as prescribed or can you set the volume to be infused at 450ml and rate @ 100ml/hr. That would leave you enough time to get a new one right, but wouldn't the pump eventually shut off or doesn't it. I know some nurses during clinical would add a few ml to the rate, they said that the medication had to be infused, does the amount in the tubing allow us to change the rate? I'm confused on this topic.
Yes you can set the volume to be infused just a bit under to give you some time to get your next bag. Most large volume parenterals have an overfill already so most of the nurses I know just set it at about 10-20 ml less that the total volume to be infused (VTBI). If you are using a new or newer volumetric pump it will default to a KVO rate once the VTBI that you set is achieved or infused. The one we use is set at 3 ml per hour unless of course the original rate is lower. It also alerts at the KVO rate constantly until attended to. You need to read the pump IFUs for the product that you have to see if it will default to a KVO rate on a primary infusion
I always had my next bag ready to go hanging on the IV pole. I also did this if the bag was getting low near shift change and reported that off to the oncoming nurse. Your coworkers will appreciate it.
You should never ever up a prescribed rate that is a medication order legally prescribed by a licensed practitioner . So if the rate is to be 100 cc per hour DO NOT up it to 110 cc per hour or EVER try to play catch up if the IV had to be stopped for any reason. This is the same for any overfill in a piggyback so if you are running it at 250 cc per hour and it still has some medication that has not infused just add some more volume and keep the rate the same. You could also add some volume so for example if the mini bag has 100 ml but usually has 10ml overfill..yes you can add that to the VTBI for the secondary. In many cases you do have a say in the rate of infusion for example unless specifically ordered you can adjust the rate of a blood transfusion as long as you do not exceed the 4 hr limit. There are also many IV medications that may have a range for the rate of administration and some that will have a taper up or ramp up as in IVIG administration.
Last edit by iluvivt on Jan 9, '13