IV infusion volume rate on Pump

klone, MSN, RN · Jun 29, 2011

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** · Jun 29, 2011

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 · Jun 29, 2011

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.

netglow, ASN, RN · Jun 29, 2011

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 · Jun 30, 2011

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 · Jun 30, 2011

I usually set it for 950ml.

carolmaccas66, BSN, RN · Jun 30, 2011

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 · Jun 30, 2011

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 · Jun 30, 2011

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

cherrybreeze, ADN, RN · Jun 30, 2011

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 · Jun 30, 2011

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.