Burette

We have a new employee that has been working in a PICU/NICU setting at a larger facility. She cannot believe that we do not use burettes on pedis. We use the Abbott Plum Pump that should eliminate the need...it has free flow protection and you set the volume to be infused. Anybody out there still use burettes?? Should we revisit the issue??? If the nurse uses the pump right there should be no need. What do you think?

I'm not currently working, so things may have changed since my last job, BUT I agree that a Burette is an important safety device. Pumps can malfunction or be incorrectly programmed, 2 situations where a Burette would offer substantial protection to the patient. In my experience, they offer cheap insurance against complications of fluid overload, especially for neonates and infants.

our policy states that we use them on pts. that are 5kg. or <. can trust your pump not to malfunction.>

I don't know what a burette is. Can someone enlighten me? Is it the same as a buritol? (sp?)

I don't know what a burette is. Can someone enlighten me? Is it the same as a buritol? (sp?)

It is a "chamber" that is placed between the bag of fluid and tha patient. You place no more than 1 hours worth of fluid in the chamber and then clamp between the bag and the chamber...It "MAKES" you go and refill and hopefully reassess the IV site hourly. Supposed to limit the amount of time between reassessments.

Buratrols are also used to give meds on patients who are bigger than 15-20 lbs. We use infusion pumps on the little ones, and use the 50-100cc baggies when they get to 12 or 13 years old.

It is a "chamber" that is placed between the bag of fluid and tha patient. You place no more than 1 hours worth of fluid in the chamber and then clamp between the bag and the chamber...It "MAKES" you go and refill and hopefully reassess the IV site hourly. Supposed to limit the amount of time between reassessments.

That makes sense! But in the real world, you don't always have time exactly one hour from the previous assmt. to get to the pt. It may be ! hr and 5 mins, or even 57 mins. How do you handle this? Just put a little extra in>

That makes sense! But in the real world, you don't always have time exactly one hour from the previous assmt. to get to the pt. It may be ! hr and 5 mins, or even 57 mins. How do you handle this? Just put a little extra in>

That is the purpose of the burette, to make you reasses. If you start with a little extra this time, then a little extra next time....Next thing you know you put 3-4 hours worth in and you get busy, don't check your pt, scalp vein blows, IV continues to pump..............

It is a "chamber" that is placed between the bag of fluid and tha patient. You place no more than 1 hours worth of fluid in the chamber and then clamp between the bag and the chamber...It "MAKES" you go and refill and hopefully reassess the IV site hourly. Supposed to limit the amount of time between reassessments.

We put 4 hours worth in our buretrols. We do sometimes leave the clamp open and let it go through the pump if it's an older child.

We used to use them all the time then our previous pharmacy director cut them due to costs. We then had 1 insulin incident and 1 narcotic incident, both in the PICU, both on plum pumps. It looks like it was the pump gone wild, so now we use the buretrols on any child under 1 year of age. We use them also for HAL and continuous Chemo. We put in 2 hours worth.

we put 4 hours worth in our buretrols. we do sometimes leave the clamp open and let it go through the pump if it's an older child.

we do the same, which kind of defeats the purpose of the burette. we are using a pump, with the automatic clamp. if it comes out of the pump, it's supposed to turn off.

one of the other advantages is giving a medication in the smallest amount of fluids allowed. if your pharmacy sends the med up in a syringe, then you squirt it into the burette, and add the appropriate amount of ivf. no 'piggy-backs'.

We used to not use burettes. Then the unthinkable happened! A 24 weeker got an entire 500ml bag of HA! She was to have her CNS US the next day. She ended up with multiple preemie problems but who knows how much it had to do with the HA.... I think they found the plum pump had malfunctioned. I felt sorry for the nurse, who was 35 weeks pregnant at the time.