IV rates

[lvnurs9]

Do you run rates less then 0.1ml/hr? Do you push meds less then 0.1ml or do you dilute?

I know there has been a thread about this, but I want to know what the standard is NOW around the country.

I was told that the manufacturer of the syringes DOSN'T guarantee volumes less then 0.1ml. We had to dilute anything that would run below that. Dopamine in tiny kids is an example. We would use 800mcg/ml instead of 1600mcg/ml. Same goes with giving morphine.... we did a 10:1 dilution. I mean, really, how can you push 0.04ml?? I am currently at a hospital that thinks it is ok and acts like they absolutely cannot deviate from their "standard" concentrations.... especially to accomodate this 370g baby I am taking care of....

Thank you for your input!!

[SteveNNP, MSN, NP]

We never run IVs slower than 0.1ml/hr. All our standard concentrations allow us to adjust to run at >0.1.

[lvnurs9]

Have you ever had to dilute insulin? I needed it to be 0.05u/kg/hr when we first started the drip in order for it to run faster then 0.1ml/hr... I got crap for it :) She is on 0.1u now, so we are using the standard 0.2u/ml...

[SteveNNP, MSN, NP]

Never had to dilute it. We rarely use insulin gtts. Usually only for stressed postop cardiacs, never preemies.

We just use whatever the standard conc from pharmacy is. I use it so infrequently, I can't even remember what it is.

Usually once we shut off the intralipids, preemie hyperglycemia resolves.

[elizabells, BSN, RN]

I've used insulin in a micro when the K+ was off the charts and albuterol and Kayexelate didn't work. But it's so very rare that the pharmacy always pitches a fit and demands that we call the attending, even if it's 0300. That's fun.

And yes, we do push meds less than 0.1mL, although personally I dilute them. It's not required, though.

[texas2007, BSN, RN]

Our med pumps won't let us run anything less than 0.1 ml/hr. As for meds, I will "push" anything less than .5 cc since that is the length of the medline. Then run the flush for however long the med needed to run. If it's something like Morphine or Ativan, I'll push it undiluted into the medline and then run the flush for like 10 min.

[NICU_babyRN, BSN, RN]

We do insulin gtts on micros, and the pharmacy is great about mixing all of our drips (other than insulin)so that rates can be greater than 0.1ml/hr.

We have standard concentrations but sometimes have to go away from them and use non-standard.

[nurserynurse55]

I do things pretty much like Texas2007. Our pumps have a hard time reading TB syrings and our med tubing holds 1cc of fluid, so I push and run the flush for whatever time.