Calculating IV drip rate without a pump

[chelynn]

I am orienting at a new ER. Other than peds and some meds we don't use pumps to run IVF. When a doc orders NS 250ml/hr the nurse uses the roller clamp to set the rate. I remember something about counting drips per minute but I forget the rest. In our ER we use standard tubing, 20 I think? I would appreciate any help. Also I did try to post this in Med Savy last night but so far still waiting for approval from the moderator. Thanks for the help

[Coffee Nurse, BSN, RN]

Googled "calculating IV drip rate."

First result: http://www.accd.edu/sac/nursing/math/ivprob.html

[PolandM]

IV calculation is a good skill to have but when you are in an urgent/emergent situation I don't think you have time really to count drips in a chamber. If you don't use pumps for standard infusions I would at least recommend that your manager budget for some "dial-a-flows".

[Virgo_RN, BSN, RN]

It should say on the IV tubing package how many drops per mL it is. We use tubing that is 10gtt/mL. Once you know that, it's pretty simple. Even though we have pumps in our ED, I've used this method several times due to the scarcity of pumps, or to save time. Sometimes by the time I've gone up and down all the halls scouring the rooms for a pump, I could have already set the drip rate using the roller clamp.

There are meds I would NEVER do this with. Things like heparin, diltiazem, nitroglycerin, etc., must go on a pump. But your antibiotics and fluids don't *have* to go on a pump.

If I wanted to give NS at 250mL/hr using 10gtt/mL tubing, then I would multiply 250 X 10 to get 2500 gtt/hr. There are 60 minutes in an hour, so 2500/60=41.6gtt/minute. I'd round to 42. To set at 42gtt/min, I'd close the roller clamp, then open it just a little, counting drops while watching the second hand of the clock. I'd want to get 7 drops in 10 seconds. Since there are six 10 second intervals in one minute, that equals 42gtt/min.

[tewdles, RN]

wow...old school nursing ;-)

[heron, ASN, RN]

wow...old school nursing ;-)

Yep ... good to know in a pinch. Once I got some experience with various sets, I got pretty good at guesstimating rates by eye, too.

I even ran heparin and cardiac drips by drop-counts back in the seventies.

[DoGoodThenGo]

It should say on the IV tubing package how many drops per mL it is. We use tubing that is 10gtt/mL. Once you know that, it's pretty simple. Even though we have pumps in our ED, I've used this method several times due to the scarcity of pumps, or to save time. Sometimes by the time I've gone up and down all the halls scouring the rooms for a pump, I could have already set the drip rate using the roller clamp.

There are meds I would NEVER do this with. Things like heparin, diltiazem, nitroglycerin, etc., must go on a pump. But your antibiotics and fluids don't *have* to go on a pump.

If I wanted to give NS at 250mL/hr using 10gtt/mL tubing, then I would multiply 250 X 10 to get 2500 gtt/hr. There are 60 minutes in an hour, so 2500/60=41.6gtt/minute. I'd round to 42. To set at 42gtt/min, I'd close the roller clamp, then open it just a little, counting drops while watching the second hand of the clock. I'd want to get 7 drops in 10 seconds. Since there are six 10 second intervals in one minute, that equals 42gtt/min.

Atta Girl! :yeah:

Old school nursing is back in da house! *LOL*

[SuesquatchRN, BSN, RN]

I've worked in placed where all we had was gravity and a clamp - recently!

I had to set an IV this way to pass clinicals. By the time you can do this you could set up an IV with a Coke bottle and aquarium tubing.

[CoffeeRTC, BSN, RN]

power goes out and the battery dies on the pump and you only have a few plugs that plug into the battery generator backup....Yep...you better know how to do your old fashion drip rates...

[rachelgeorgina]

We were taught this before we were allowed anywhere near a pump in school. & we were tested on it, too. They expected us to get over 90% is drip calculations.

Volume to be infused (in ML) times the drop factor over the time of the infusion (in minutes.) The answer is how many drips you need to count in the chamber by adjusting the roller clamp (which is a skill in itself!)

Different giving sets have different drop factors however the packaging will give the drop factor in a relatively clear place.

[DoGoodThenGo]

Drip rates are probably one of the more scary parts of med dose calcuations for student nurses, but as shown above (rather well indeed), it really is nothing more than basic math and knowing how to use the formula.

So many students and GNs come out of school thinking every hospital is chuck full of whizbang technology,all meds arrive on a floor pre-dosed so even a lay person could administer, and there are going to be pumps for each and every patient that requires one.

Darn skippy, if there is loss of power, another major attack, natural disaster, etc, and one is left with little or no electric/battery power, and or one has to pull meds the good old fashioned way, you better know your stuff.

Will draw the line at "old school" when it comes to glass IV bottles though! *LOL*

Does anyone remember the loud noise they would make as lot were being rolled on carts into the stockroom?

[Not_A_Hat_Person, RN]

I graduated 2 years ago, and all we did with IVs was manual drip rates and time-taping. I've never used a pump.