antibiotic infusions in pediatrics

[juliekrn]

I am working on policies related to the most effective delivery mode for IV antibiotics in the pediatric population. I would like some rationale (if there is some) of why it is better to use syringe pumps as opposed to volutrols. Any help would be greatly appreciated. Any recommendations for a good book on Pediatric intravenous therapy policies ?

[lkubin]

Syringe pumps are preferable to volutrols for two basic reasons. First, you deliver less fluid volume (the tubing is microbore, can be plugged in at the port closest to the insertion site, and the only flush necessary is 2-3 cc to clear the microbore tubing). Secondly, ALL of the medication is delivered in a timely manner. With volutrols/buretrols/metrisets, a significant amount of the medication adheres to the side and bottom of the set. In addition, you have large bore tubing that the medication must clear. Therefore, requiring you to flush with AT LEAST 20 cc of fluid to actually administer ALL of the medicine. This additional 20 cc must be added to your final volume and rate calculations. Your IV rep can give you information regarding volumes and flushing, etc. Also, use food coloring in a bag of saline (or whatever) and test it yourself.

One last comment, a large majority of medications that are used (including antibiotics) can be given slow IV push, thus eliminating all of those issues. You might want to think about that option.