Gravity NS boluses for pediatric patients?

Nurses General Nursing

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Do they ever do gravity NS boluses in peds? What if no pumps are available? Is a rapid infusion (per gravity) to fast for a ped patient to absorb or will it blow a vein?

Also what sizes do they generally use for say a 10 year old and 3 year old NS bolus? I'm guessing around 24 and 25 gauge?

Specializes in Emergency, ICU, PACU, Hospice.

No they won't get it too fast. They are smaller and have less of a gravitational pull to suck it out of the bag.

Specializes in Peds/Neo CCT,Flight, ER, Hem/Onc.

It can be done but you must use a Buretrol or stay by the bedside. If a peds patient needs a bolus you place whatever size catheter you can get in quickly. Generally a 22 is the "go-to" size but if you have to go smaller then go smaller.

In my ER, nothing on peds patients is hung to gravity, even boluses are put on a pump to maintain strict control of how much goes in.

Specializes in CEN, CPEN, RN-BC.

I use a 22 or 24, always a buretrol, and always try to use a pump. I have hung NS boluses without a pump, but always with a buretrol and never a whole liter bag.

smaller with less gravitational pull? really?

Specializes in Emergency, ICU, PACU, Hospice.

It's a physics thing. Compare it to the planets. Little Earth has less of a gravitational pull than big ole Jupiter. Therefore objects are not as firmly drawn to them. So...yes really.

Wow your knowledge of physics is quite impressive! pookafert, you contend the size of the pt & therefore that pt's gravitational pull determines speed of infusion w/a gravity drip? What does your physics textbook have to say about the height of the fluid relative to the pt? Maybe you should educate yourself b/f you cook up your next reply.

Specializes in Emergency, ICU, PACU, Hospice.

As most of us realize, with apparently a few exceptions, IV tubing comes in a standard length of 150 cm and will be a constant and the patient size the variable. So I still maintain my previous answers.

Specializes in Peds/Neo CCT,Flight, ER, Hem/Onc.

You do realize that the gravitational "pull" doesn't actually come from the patient so their size is kind of irrelevant?

http://books.google.com/books?id=rcnbw6BOMpQC&pg=PA410&lpg=PA410&dq=speed+of+gravity+infusion&source=bl&ots=FhWX1bZlOR&sig=oubxac3tDyvOWqKgr0n5vMWNErI&hl=en&ei=K92TTZjBHpCssAOJi6nIBQ&sa=X&oi=book_result&ct=result&resnum=9&ved=0CEIQ6AEwCDgK#v=onepage&q=speed%20of%20gravity%20infusion&f=false

why don't you check out what a textbook has to say - no mention of the pt's gravitational pull as a function of pt's size being a variable that determines rate of flow in a pure gravity feed iv. Perhaps you could produce a scholarly reference to back up your assertions.

FYI regardless of the length of tubing, it is in fact possible to hang the bag at a variety of differing heights relative to the IV catheter insertion site on the pt. If I am in the minority here I will be very scared for the profession.

Specializes in pediatric critical care.

We ALWAYS use a pump in my peds hospital, or we are pushing fluids by hand in critical cases, but either way it's really important to monitor the exact amount of fluid going in. Most patients get a 22 or 24 gauge, but sometimes you can get a 20 in a tween or teen, and very rarely anything larger.

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