TKO IV question

Bumashes, MSN, APRN, NP · Mar 9, 2009

anyone know what is the right ml/hr for TKO. I thought it was 10ml/hr but i could be wrong. please verify and if your have a resource please let me know. thanks a bunch.

At my hospital we call it KVO (keep vein open) and run at 20-25cc/hr. However, it does help to give a good strong flush every 8 hrs or so anyway cuz 20cc/hr won't keep crud from clogging the tube indefinitely.

S.T.A.C.E.Y, LPN · Mar 9, 2009

Everyone always has a different number. Usually something less than 50 ml/hr.

Common rates I've heard people state/defend:

10ml/hr, 30ml/hr, 35ml/hr

I have never heard of any solid references for any number, but there has been a suprising number of people defend their preferred number to the death.

Daytonite, BSN, RN · Mar 10, 2009

xj3nnerz. . .tko (to keep open) is a generic term that is used by many doctors in a quick moment. it is not a clear order that contains all the elements required for an iv, however. from page 155 of intravenous therapy: clinical principles and practice, by judy terry, leslie baranowski, rose anne lonsway and carolyn hedrick. . .

a fluid order for iv fluids must contain the type of fluid and amount, any medication and dose, route of administration and flow rate:

"[the flow rate] must be specified, and the nurse is responsible for calculating the rate. . .a fluid order that specifies a keep vein open (kvo) flow rate is incomplete, and the physician should be consulted for a definite hourly rate. (the exception on this is an institutional policy agreed on by the medical and surgical staffs as to the definition of a kvo rate [kvo = 20ml/hour].) otherwise, this notation for a rate is the decision of each nurse caring for the patient and has legal implications, in that each nurse's definition of kvo might be different and difficult to defend."

i am an rn and worked on iv teams for many years as well. every hospital that i worked in had a policy that specified exactly how fast a kvo order was to be infused in the event that a doctor did not specifically order a kvo rate that he wanted. these kvo rates varied from hospital to hospital.

you also need to know that most electronic iv pumps default to a kvo rate that is pre-programmed into its software when the pump has delivered its set volume. this rate can be found in the company's literature, but is often 1 ml/hour.

when you say, i thought it [kvo] was 10ml/hr, that could be the kvo policy at the facility where you have been doing your clinicals. next time you are at that facility, check their policy and procedure manual for something that addresses kvo orders.

mzjennx, BSN, RN · Mar 11, 2009

wow thats for the feedback. i will definately inquire the stardard protocol for TKO. as far as NCLEX though, Kaplan says 20ml/hr.

i take my NCLEX thurs... wish me luck.