How do you change the I.V. drip rate?

[Trauma_Team_1]

Hi everyone I just have a quick question. How do you adjust the drip and flow rate for a gravity feed I.V. ( no pump)? Thank you.

[SaraO'Hara]

i was wondering the same thing that spiker did, and the answer is probably yes, they do rely on pumps, so calculating the gtt rate is a lost art...makes me feel old...or should i say older? sheila c

bullfeathers. i just graduated in may, and we had (in iv certification class) to be proficient in manually calculating / adjusting the gtt rate before they let us learn how to use the pumps. in my area, blood is often still run in by gravity.

[KaliNurse]

Yes, Sara you are correct. Yes, you still need to know how to do the calculation MANUALLY. However, plum pumps are now being used more often to avoid unecessary mathemathical errors. Nursing schools will always continue to teach the original concept, as I do with my nursing class. But, in the real world....you won't have to figure it out per say. But, you WILL have to CHECK it once it is calculated for you. So it's always good to know it, and more importantly, keep it in your head for future use.

As far as blood goes.... it depends on the facility's "Standards of Care". Our facility also runs blood to gravity at this point in time. The reason is not because of possible mistakes that could be made, or not being able to correctly calculate gtts/min when infusing blood. The reason is.. research says that a "coagulation problem" may occur when infusing blood through a pump. As we know with the pump, the solution goes through a cartridge which somehow could create a "coagulopathy effect". Therefore, some facilities still hang it to gravity. Other facilities stick to the pumps based on past experiences and past research which disputes the whole "coagulopathy effect". It all depends on your hospital/facility.

Always check the Standard of Care for the facility.

You make good points!! Hope this helps! ~ Kali

[BelleKat, BSN, RN]

Sheila:

Don't feel "old" or "older"!! The bottom line is times are changing. There is research that supports using plum pumps, as opposed to manually calculating things. There is less chance for mistakes. There are also mandates at certain hospitals for using them, especially in cases of infusing high-risk drips such as heparin, insulin, dopamine, and don't forget.....blood too! Some pumps are equipped with a library that contains each drug and its concentration. You plug in the #'s and the pump calculates the rate. Should you still check to make sure? Well, yes. But do we? Well, no. Remember, the pump itself doesn't make mistakes. People who program the pump make mistakes!!!!! I rely heavily on them.

All of us learned how to calculate these things in nursing school back in the day. However, relying on modern technology has made us forget the "old" way of doing it. I still believe in using the pumps whenever possible. If that is not possible, then BE SURE to have someone else double check your math!! ~ Kali

Yep,we know. I was referring to the fact that something that was taught in nursing school is seemingly no longer taught.

I've been using infusion pumps and computer based charting in ICU settings since the 80's.

Also sometimes the programs in the plum pumps aren't accurate yes it's a programmer error but you need to be able to figure out even drip rates with a calculator if you need to.

[Spiker, ASN, RN, EMT-P]

Hey, we're not old! Just really experienced in a lot of nursing skills!!!