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: 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.
"[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."