Fluid Bolus question

[Maria1308]

I'm a new nurse tech in the pediatric department. Normally the nurses do not like to run fluids on infants or newborns at a high rate because these patients veins are small and the risk of blowing the vein is high when the rate is high. I'm a little confused as to what happens when an infant would need a bolus of fluids for rehydration. Wouldn't the rate for the bolus be higher. The bolus is normally given prior to the patients admission in the pediatric area. Was wondering how is it done at other facilities?

[Burnvegas]

Run in a fluid bolus over fifteen minutes, regardless of the volume. the rate will change depending on the volume, so the lower the volume, the lower rate will actually be.

[KelRN215, BSN, RN]

Run in a fluid bolus over fifteen minutes, regardless of the volume. the rate will change depending on the volume, so the lower the volume, the lower rate will actually be.

I've been a pediatric nurse for 10+ years and have never administered a fluid bolus to a child over 15 minutes.

Fluid boluses in pediatrics are usually 10-20 mL/kg and we usually administered them over an hr, sometimes 2 if we were concerned about the IV access. I will say, however, that these were not cases of sepsis where the fluid was needed immediately but subtle signs of dehydration like mild tachycardia or failure to void or vomiting accompanied by mild hypotension.

[Coffee Nurse, BSN, RN]

I'm pretty used to running a 10 ml/kg bolus on a neonate over 30 minutes. To the OP, I think the reasons for not running fluids at high rates in babies are more: a) it takes much less volume to effect a major fluid balance change in a very small person so it's preferable to infuse boluses more slowly, and b) a baby's fluid requirements are much less than an adult's, so divided over 24 hours will obviously mean a lower rate. In an emergency, you can push fluid boluses, blood products, anything you have to through a 24G catheter, it doesn't automatically mean that the vein will blow.

[Maria1308]

Thank you 🙏🏾 so much. I'm always confused as to if the bolus would cause the iv to go bad or being that the patients are small, fluid volume overload can occur.