Antibiotic without the IV pump

llg, PhD, RN · May 5, 2017

The question isn't whether or not you CAN run an antibiotic without a pump. Any fluid CAN run through the tube by gravity alone. Back in the old days, before the use of pumps was common, lots of stuff was administered IV without a pump. Believe it or not, IV's existed long before any pumps did -- and everything ran without a pump.

The real question is: What is you employer's policy regarding the use of pumps. Are they required for everything? For all antibiotics? What does the policy say? Policies can differ between institutions and even in the same institution between different specialties.

You need to locate your employer's policies and review them.

~Mi Vida Loca~RN, ASN, RN · May 5, 2017

The question isn't whether or not you CAN run an antibiotic without a pump. Any fluid CAN run through the tube by gravity alone. Back in the old days, before the use of pumps was common, lots of stuff was administered IV without a pump. Believe it or not, IV's existed long before any pumps did -- and everything ran without a pump.
The real question is: What is you employer's policy regarding the use of pumps. Are they required for everything? For all antibiotics? What does the policy say? Policies can differ between institutions and even in the same institution between different specialties.
You need to locate your employer's policies and review them.

Exactly this! Check your facilities policies, it's the only thing that will save you if something goes wrong.

We run abx without pumps in the ER all the time (I know the horror, I am sure people are gonna be ready to tell me how unsafe that is etc etc.) but there are certain meds we are not allowed to run without a pump in our policies and reminders are posted in the med rooms. Although it's pretty standard for us that anything that has to go in over 30 mins we put on a pump.

brownbook · May 5, 2017

llg is correct. However if your policy and procedure manual doesn't clearly state the route or rate of medication administration you can also use the guidelines in a recent edition of an IV medication book. Ideally your facility would have an IV medication book in the medication room or chained to each medication cart. I'm showing my age..... I suppose there are "apps" you can use also.

Where I work we routinely give a gram of cefazolin in a 10 ml syringe IV push. However I am NOT working in a nursing home facility.

vuphan86 · May 5, 2017

thank you for all your input. How can i check the policy of the facility? I don't want to ask my preceptor that giving the IV without the pump is in the policy or not. my preceptor said not all the antibiotic can run without pump such as Vacomyocin needs a pump.

brownbook · May 5, 2017

thank you for all your input. How can i check the policy of the facility

You have to ask a co-worker or charge nurse. Every facility has to have a policy and procedure manual. These manuals can be big, cumbersome, and hard to find what you need. The can even become out dated. If, when, you find the sections that seem pertinent to you, i.e, what to do when a patient falls, you can copy those few pages and keep thm in your locker or somewhere you can easily access them.

~Mi Vida Loca~RN, ASN, RN · May 5, 2017

thank you for all your input. How can i check the policy of the facility? I don't want to ask my preceptor that giving the IV without the pump is in the policy or not. my preceptor said not all the antibiotic can run without pump such as Vacomyocin needs a pump.

I would agree with her on that. Vanco usually runs over 60-90 mins for most doses I have seen. (I am sure this can vary) but I have never seen it run less than an hr. Rocephin is one we never put on pumps. I'm thinking you should have been told where to find policies and stuff during orientation. But I have never worked LTC so I am not sure how it's run. Everywhere I have worked you can find them in the Intranet for the hospital. But I would ask your preceptor just a general where do you find them. You don't have to tell them what you're wanting to know for because it's something you need to no regardless.

oceanblue52 · May 6, 2017

thank you for all your input. How can i check the policy of the facility? I don't want to ask my preceptor that giving the IV without the pump is in the policy or not. my preceptor said not all the antibiotic can run without pump such as Vacomyocin needs a pump.

You could frame the question more generally by asking what policies are in place for administering IVs...any decent employer will be happy that you are following protocol and being proactive in your learning.

KelRN215, BSN, RN · May 7, 2017

Good morning everyone.
I am a new nurse in nursing career and have so many questions but one of the question i would like to ask the most is that in Nursing Home facility, my preceptor told me that the some of Antibiotic such as Cefazolin can infuse without IV pump. she said I can adjust the rate or the drop by using roller clamp. Is it True? Thank you for all your help and i am appreciated !!!!

Cefazolin (and Cefepime, Ceftazidime and Ceftriaxone) can be given IV push. It's done in home infusion all the time. Not for my patients because the pediatric hospital I liaise for doesn't allow IVP but for adults, it's pretty standard.

RNrhythm, BSN, RN · May 11, 2017

You are rockin' it old school.

kp2016 · May 12, 2017

Reading posts like these I realize I am officially an old nurse. When I started nursing most hospitals only had enough pumps to be used for drugs which presented a very serious danger if infused too quickly. All new nurses had infusion rate cards on their IDs to help them time the infusions. All the Cefazolins where given by slow push.

As you are a new nurse part of your orientation should have been to at least be aware of how to access your unit and hospital policy and procedure manuals. Ask your preceptor as a general question where these are located and spend some time reviewing them. If the infusion policy isn't specially stated here call the pharmacy and ask them to clarify the policy for you.

Kooky Korky, BSN, RN · May 14, 2017

thank you for all your input. How can i check the policy of the facility? I don't want to ask my preceptor that giving the IV without the pump is in the policy or not. my preceptor said not all the antibiotic can run without pump such as Vacomyocin needs a pump.

But she didn't bother to show you the P & P Manaul? The Pharmacy Manual? Other Manuals?

There should be a Policy and Procedure Book on your ward. You need to read all of the manuals that are (should be) on your ward. They are not there for decoration and you will learn a lot by reading them again and again and again until you know them in your sleep.

These manuals contain the rules that your employer holds you to. I'm shocked that no one has informed you of them before now.

Policy could vary from ER to OR to ICU to Med/Surg to every different floor. So wherever you are working, find those manuals and learn them inside and out.

Best wishes.