IV Bolus not so simple

Gldngrl · Sep 21, 2003

It depends on how fast you need to infuse the bolus, what kind of access you have, your pt's condition and their ability to tolerate a rapid bolus. Normally, I set my pump volume at its highest infusion rate "999" and set the volume to be infused at 500 or whatever was ordered, but this is going thru a central line in postop abd. surg. patients that are hypotensive d/t hypovolemia and can handle the fld. Sometimes if you have a smaller gauge peripheral access, the pump is going to beep off if you try running fld thru that fast or you'll blow your access so you need to run it slower. We also have a hospital policy that we can't run anything off pump. MMB

TaraER-RN · Sep 21, 2003

you could always set the pump like MMB said above as the piggyback mode and then set the regular infusion at whatever it is suppose to be after the bolus is done...thats what I do sometimes

bellehill, RN · Sep 21, 2003

I usually get a 500cc bag (or whatever is ordered), set it up as a piggyback as fast as the patient can tolerate. Setting it as a piggyback with allow the fluid to switch back to the original setting without beeping and bugging everyone.

Most pumps clamp off when the tubing is in the loading chamber. Perhaps this is why the NS wouldn't flow by gravity?

alansmith52 · Sep 21, 2003

sometimes the petty things that befuddle us atounds me.

ohbet · Sep 21, 2003

Well thank you for replies. I wonder why we dont have a P and P on this.

Editorial Team / Admin · Sep 21, 2003

In the same way we're not to use TKO or KVO anymore (a rate must be specified in the MD orders), I would think the term "bolus" is too general/vague. I would extract from the ordering MD the rate of the infusion (based on, as others have noted above, pt's ability to handle rapid influx of fluid) as well as the amount. It just seems safest to me, unless there is a P and P set up, approved by the MDs (which, IMO, is still subject to the pt's condition).

Elenaster · Sep 22, 2003

I usually help gravity with a pressure bag when I'm running a bolus. If you have time, you can take a syringe and remove all the air from your bag so your tubing won't run dry.

grneyes676 · Sep 22, 2003

Most pump tubing can be ran just as gravity...just dont put it in the machine. It depens on what pumps you use, but there is some sort of clamp that is on the tubing part that would go into the machine, you use that just as if it were a roller clamp.

I prefer to run my boluses by gravity if it is a PIV, that way the run at there own rate, not with to much pressure, less chance of blowing your IV!!

ohbet · Sep 22, 2003

More helpful replies,thank you.