No more buretrol/burette?

Pediatric Critical Care Columnist · Jun 12, 2008

Doing that would require a HUGE change in practice for my unit. Of course, PICU is always different from the general floors... We use the buretrol to add aliquots of electrolytes (most commonly potassium) to our maintenance fluid or TPN. We rarely add KCl to the bag because our patients' K+ levels fluctuate too much and it's much easier to control how much we're giving this way.

Jolie, BSN · Jun 12, 2008

I suspect that your unit is simply looking to save money, at the expense of an important safety device. Unless you give everything by syringe pump, it is my personal opinion that every IVF should have a Buretrol as a safeguard against pump failure and programmer error.

MikeyJ, RN · Jun 12, 2008

It is definitely a move on administrations part to save money, but apparently they indicated to management that most hospitals no longer use buretrols.

We have syringe pumps but not enough to accomodate the # of patients we have. It will be very interesting to see how they propose we run an antibiotic that comes in a syringe without a syringe pump.

luvdancink · Jun 12, 2008

Keep us posted. Some of our staff would love to go to syringe pumps only.

tartay0211RN · Jun 16, 2008

I am a traveler and have come across this question several times, I personaly do not like using the buretrol but I started my nursing career at a hospital that did not use them on the pediatric ward we used syringe pumps for syringe meds or we used IV tubing that had the capability to run syringes through the secondary port. I have been to a few hospitals now that are transitioning over and have had no ill effects except maybe some disgruntaled nurses. Most IV tubing has a back up clamp and if the pumps are programmed correctly there is no need for a buretrol. In the old days before decent pumps, we had to calculate drip rates with the roller clamp and errors could be made very easily so in this instance they were a good back up system but not really needed anymore. Hope this helps. I have never seen any research on this, this is just my own personal observation.

pedseducator · Jun 17, 2008

Do those who do not use buretrols, use Smart Pumps and this is why you switched to just plain IV tubing? What is your success like? Any safety issues? Thanks my sisters and brothers in nursing

AdobeRN · Jun 18, 2008

We use the Alaris pumps and do not use Buretrols. The tubing has a special clamp on them. We also have a policy to check the pump & IV site every 2 hours. We only program the pump to run enough fluid for those 2 hours. If we have an antibiotic to run, we use the sryinge pumps.

peds.rn.2003 · Jun 18, 2008

we use "smart" :confused:pumps in our peds dept. sometimes we have to use bard mini infusers because the ivpb clave fails. i have never seen a buretrol or burette although i have heard of them. pharmacy mixes the bags when we have to give kcl--which isn't often

WineCountryRN · Jun 19, 2008

Burette~ used to protect accidental fluid overload and for adding meds to the IV lines but I think most nurses who use burettes have more than the 2 hours of ordered fluids in them with the IV pump set VTBI at more than 2 hours. I don't think that burrette are being used by 80% of the pediatric nursing staff at this peds hospital in the manner that they were designed for and instead are just using them for adding meds. IDK,,,that is just my observation only.

nocangel2 · Jun 27, 2008

To add, no buretrols for us except for NICU pts. I've been here 6yr and no problems. Our primary pumps have a secondary port for meds and we use the Med infusion and Bard syringe pumps as well. Don't worry!

SteveNNP, MSN, NP · Jul 2, 2008

In my experience, buretrols only work when the staff uses them properly. I used to come into NICU and see 50-75 cc in the chamber, on an IV that was running at 1cc/hr. We then switched over to regular tubing with q1-2h checks, along with programming in only 2 h worth of fluid. Free-flow protection is now on almost every newer IV pump. There is really no need for buretrols unless you have no syringe pumps. Our manager always made sure we had enough Alaris SP modules to infuse all our meds, K runs, etc... I only remember having to add stuff to a buretrol once, in all my days in NICU, PICU and peds.....