Technically you do not need a TKO or KVO rate to keep it patent. If that were true that locked venous access devices would always clot off and that is not the case. A KVO or TKO rate just provides an added convenience for the patient and the nurse in addition to some IVFs. There are many factors that cause venous irritation and that has a lot to do with the ph and osmolarity of the drug and how far away those numbers are from normal blood. The quality of the vein its location and the size of the cannula are also factors.The goal is to get as much hemodilution as possible when infusing irritating medications, There are also a lot of medications that are inherently irritating no matter what you do!
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TKO...to keep vein open. Difficult sticks this helps in retaining the IV site by preventing clots and like ilutit says with PCA pumps to allow a way for the drug to be delivered at a steady rate and minimal fluid