I have a question among many many questions

MissJoRN, RN · May 28, 2005

Hi
As I always come to this thread with questions which will always happen from me lol.
I have a question when it comes to IV Infusions Keep Vein Open. I just would like more information for the reason to keep vein open? Does KVO mean for when a patient is kept on fluids? Or does it mean its applied when the pt after having IVABs that the fluid in the bag needs to go thru to keep vein open?
I would love to know more about it.
Thanks :)

KVO (also TKO- to keep open) is usually a rate of 25 in adults, lower in pedi, to keep the IV cath patent with just enough pressure from the line to balance venous pressure from backing blood into the cath where it can clot. I'm honestly not sure when a KVO is preferred in adults over a NSS lock, it is routinely used on my peds floor. They do make intermittant IV meds- pushes or IVPB easier, in my opinion. Also, I imagine reduce risk of infection- fewer accesses to line for flushes, no stagnation. When you do use an IVPB on a KVO line, you need to remember to use a secondary rate on your pump- I set mine for the entire volume of the med bag + 5-10 cc to pull off the primary to flush.

elkpark · May 28, 2005

Also remember that most facilities have a nursing policy/procedure that specifies what the approved KVO rate is at that facility -- like anything else, when you have a KVO order, be sure that you are following the facility P/P. :)

Daytonite, BSN, RN · Jun 4, 2005

TKO IVs were more common before Heparin locks, Heparin wells, or saline locks were used. It was a way to keep an IV access, especially if the patient was on IV antibiotics or IV push medications. Honestly, they are kind of outdated since the aforementioned locks have become so prevalent. However, back in the 70's Heparin locks/wells were not considered common and were only seen in the ICU/CCU's where patients were on restricted fluids. Also, if we could see the fluid dripping in the drip chamber and the IV site looked OK we were pretty sure we had a patent IV. You can't always determine that about a Saline lock until you attempt to flush it.

The only current reason for them would be to already have the IV tubing up, primed and ready to recieve another bag of fluid, blood or medication. And, yes, each facility should have a policy detailing the rate for a TKO IV when one is not specified by the physician.