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IV infusion volume rate on Pump

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Hi everyone I have a quick question. If someone is receiving Dextrose 10% with Potassium 75ml/hr continously and the amount in the bag is 1000ml, would you set the volume to be infused on the pump at 1000 or make it 900ml. I asked this because I remember a clinical instructor saying put in a 100ml less thats on the bag I guess so it won't run dry. And another question is that the volume to be infused the 1000ml on the bag or does calculation needs to be done instead. Just asking because I haven't worked with Ivs in a while, and might have one at work. Thank you for any advice and help.:)

klone, MSN, RN

Specializes in Women's Health/OB Leadership. Has 15 years experience.

They tend to overfill the bags slightly to account for priming and such, so generally, setting it for 1000 won't cause a problem. I generally set it for 980. Setting it for 900 leaves it with a lot of waste in the bag, which you either have to throw out, or come back 30 minutes later to change the bag anyway.

I don't understand your second question.

NickiLaughs, ADN, BSN, RN

Specializes in Emergency, Trauma, Critical Care. Has 12 years experience.

Most IV pumps do not change the amount and no additional drug calculations would need to be done if you gave yourself a "save" period so the line doesn't run dry. I usually do around 30-50 mL less than the bag states it has If it's a 1000 mL bag, 970 max for me. My coworker and I were curious one day (it was a slow day at work) so we actually took Iv tubing that was primed and emptied it into a container to see how much fluid was in it, we got around 30 mLs. We use alaris pump tubing btw. So just a heads up for nurses, when you prime tubing, I would at least minus 35 mL or so, because you assume the tubing and a few mL's are wasted when primed. :)

merlee

Has 36 years experience.

I used to set my pumps for 950 - gave me plenty of time to get the next bag ready if I hadn't done it yet.

Assuming you are working with adults, and at least 950 infused, I would enter 1000 as my intake.

OK, I re-read that second part.

You set the pump based on the volume in the bag. However you need to also look at your orders. Orders may say infuse the entire volume (whatever that may be) over a certain timeframe but the order does not say what the rate should be (you'd calculate that, depending on your pump), or, the orders may say infuse the entire volume at Xml/h. Just depends on your facility and how things are supposed to be ordered in the system.

JustaGypsy

Specializes in ER, SANE, Home Health, Forensic.

All IV tubing has a "drop set" number, and also should say on the package the volume required to prime. I too give myself a 50 ml window...

NeoPediRN

Specializes in Pediatrics, ER. Has 6 years experience.

I usually set it for 950ml.

carolmaccas66, BSN, RN

Specializes in Med/Surg, DSU, Ortho, Onc, Psych.

Don't ever do anything without checking your facility's policy, otherwise you are legally responsible. Just ask the senior nurse when you get there.

I never bothered with that. Some people punch in 999 mls, but why? The IV should be checked throughout the shift, and will have to be changed/discontinued (depending upon other IV orders). The pump won't deliver air to the patient anyway and it will beep when done. Also the Dr will want the medication to be delivered to the patient in a certain time/dosage for a reason, so if the pump is set not to deliver the last 100 mls as you said, and no-one gets to check the pump on time to re-set it, you might have one very angry Dr confronting you as to why the IV hasn't infused over a certain time period (I saw a RN get hauled over the coals for this, that's why I've put it on here).

You should be checking your IVs every hour anyway so I don't see the point setting the pump at 900 mls or whatever.

carolmaccas66, BSN, RN

Specializes in Med/Surg, DSU, Ortho, Onc, Psych.

Hi everyone I have a quick question. If someone is receiving Dextrose 10% with Potassium 75ml/hr continously and the amount in the bag is 1000ml, would you set the volume to be infused on the pump at 1000 or make it 900ml. I asked this because I remember a clinical instructor saying put in a 100ml less thats on the bag I guess so it won't run dry. And another question is that the volume to be infused the 1000ml on the bag or does calculation needs to be done instead. Just asking because I haven't worked with Ivs in a while, and might have one at work. Thank you for any advice and help.:)
'

You need to go back and review ur IV formulas if you can't work this out, otherwise you're going to be struggling. You always need to calculate IVs and double check them, just to be sure. Some pumps you just punch in what you need to infuse and it calculates the drip rate for you, but you need to check your pumps can do that.

sonja77

Specializes in medical, telemetry, IMC. Has 6 years experience.

I set the volume for 1L bags at 950ml.

cherrybreeze, ADN, RN

Specializes in Med/Surg.

Don't ever do anything without checking your facility's policy, otherwise you are legally responsible. Just ask the senior nurse when you get there.

I never bothered with that. Some people punch in 999 mls, but why? The IV should be checked throughout the shift, and will have to be changed/discontinued (depending upon other IV orders). The pump won't deliver air to the patient anyway and it will beep when done. Also the Dr will want the medication to be delivered to the patient in a certain time/dosage for a reason, so if the pump is set not to deliver the last 100 mls as you said, and no-one gets to check the pump on time to re-set it, you might have one very angry Dr confronting you as to why the IV hasn't infused over a certain time period (I saw a RN get hauled over the coals for this, that's why I've put it on here).

You should be checking your IVs every hour anyway so I don't see the point setting the pump at 900 mls or whatever.

Our policy was to set the pump for 950.

True, the pump won't deliver air to the patient, but with the pumps we have, once air gets in to the top of the tubing, you have to reprime the whole set (the pumps we had before these kind, the tubing had "pillows" which allowed you to "push" the air back up in to the bag easily, but that's not an option anymore). You have to detach it from the patient to reprime it, and you never want to open up the set if you don't have to. Setting the pump for slightly under the volume is an easy way to make sure this doesn't happen.

Of course, it would be IDEAL to be able to check all of your IV's every hour, but let's be honest....nothing in nursing is ideal. Better to play it safe and have another back up, since there is no downside to doing so.

lckrn2pa

Specializes in ER. Has 19 years experience.

Every nurse does it different. I always set my volume less by 1 hour of the rate. If my IVF rate is 125, then I set the vol to infuse at 875, this gives me an hour to get a new bag. How many times has your IV vol infused alarm gone off at 3am and your out of that particular IV fluid and the house sup is tied up somewhere else. This gives you a cushion to get ready for the next bag. Not really anything to work out, it's a matter of nurse preference.

carolmaccas66, BSN, RN

Specializes in Med/Surg, DSU, Ortho, Onc, Psych.

Our policy was to set the pump for 950.

True, the pump won't deliver air to the patient, but with the pumps we have, once air gets in to the top of the tubing, you have to reprime the whole set (the pumps we had before these kind, the tubing had "pillows" which allowed you to "push" the air back up in to the bag easily, but that's not an option anymore). You have to detach it from the patient to reprime it, and you never want to open up the set if you don't have to. Setting the pump for slightly under the volume is an easy way to make sure this doesn't happen.

Of course, it would be IDEAL to be able to check all of your IV's every hour, but let's be honest....nothing in nursing is ideal. Better to play it safe and have another back up, since there is no downside to doing so.

I don't know re other countries nursing policies, but in Aust we MUST check our IVs every hour. We also must record in the fluid balance chart the rate the pump is going at. It has to be done every hour, and is part of our nursing requirements. It's like checking urine output every hour and recording it - it just has to be done.

I don't know re all different types of pumps, but I find (as an agency nurse) it's always best to check the facilities policy, but I've never had a problem just setting the pump for the full bag - each to their own. You also should be checking the Drs requirements as well - they might want a lot of fluid and or medication to go through quickly so best to double check that, rather than messing around with re-setting amounts, etc.

Don't you have pumps where you can push the air back up into the bag, (can't remember the term just off the top of my head as have a tired headache). You just push a button a couple of times and it pumps the air back up the line, back priming is it? (correct me if I'm wrong).

Five&Two Will Do

Specializes in cardiology/oncology/MICU. Has 3 years experience.

I don't know re other countries nursing policies, but in Aust we MUST check our IVs every hour. We also must record in the fluid balance chart the rate the pump is going at. It has to be done every hour, and is part of our nursing requirements. It's like checking urine output every hour and recording it - it just has to be done.

I don't know re all different types of pumps, but I find (as an agency nurse) it's always best to check the facilities policy, but I've never had a problem just setting the pump for the full bag - each to their own. You also should be checking the Drs requirements as well - they might want a lot of fluid and or medication to go through quickly so best to double check that, rather than messing around with re-setting amounts, etc.

Don't you have pumps where you can push the air back up into the bag, (can't remember the term just off the top of my head as have a tired headache). You just push a button a couple of times and it pumps the air back up the line, back priming is it? (correct me if I'm wrong).

I wish we had pumps that would back prime with the push of a button! We have alaris pumps which I like because of the guardrails system. I don't really have a problem with my pumps sucking air. I might short chang a liter by 50ml's or a IVPB by 10ml's, but I always make sure the patient gets all of the drug. We do I&O every hour on everyone too. I look at IV's to ensure no infiltration as well. Let's face it, unless one of mine is crashing, I am usually watching them sleep for most of the night. It's not like I don't have time:D

nyrn5125

Specializes in pcu/stepdown/telemetry.

this isn't rocket science. my facility doesn't have a policy on setting the pump for a 1 liter bag. we use our nursing judgement to leave us enough time to get another bag, set it to leave you 100cc of leeway. on days with eight patients doesn't usually allow us to be in the pt room each hour

cherrybreeze, ADN, RN

Specializes in Med/Surg.

I wish we had pumps that would back prime with the push of a button! We have alaris pumps which I like because of the guardrails system. I don't really have a problem with my pumps sucking air. I might short chang a liter by 50ml's or a IVPB by 10ml's, but I always make sure the patient gets all of the drug. We do I&O every hour on everyone too. I look at IV's to ensure no infiltration as well. Let's face it, unless one of mine is crashing, I am usually watching them sleep for most of the night. It's not like I don't have time:D

We have Alaris pumps, too, so nope......no way to get air back out of the tubing, once it's in there.

I agree, too, if there is enough left in the bag I'll reset it to infuse as much as I can "without going over" (kind of like the Price is Right...). It gives me time to make sure I have another bag ready to go, though.

this isn't rocket science. my facility doesn't have a policy on setting the pump for a 1 liter bag. we use our nursing judgement to leave us enough time to get another bag, set it to leave you 100cc of leeway. on days with eight patients doesn't usually allow us to be in the pt room each hour

I used the word "policy" but that probably wasn't the right word....more like "unwritten guideline." We have it that everyone does it the same way so there isn't confusion if you hang a bag for someone else, etc. It's common knowledge that we all set them the same, just makes it easier.