IVPB infusion rate

[theviolinist]

Hello,

I need help making sense of infusion rates for IV piggybacks. So, last week at clinical I had an IVPB medication that was 250 mg in 200 mL to give over an hour. However, we decided to slow the rate to 150 mL/hr since my patient was elderly. That's where I'm stuck. Can someone explain how to figure rates out? Sorry, I'm just confused.

[Kuriin, BSN, RN]

I'm a little confused on that, too, since it's going against orders?

[4boysmama]

that does seem a bit odd...

What was the medication? What was the pt's admitting dx? I can see the rate being questioned if this was a heart failure pt or some other fluid volume issue (renal, etc)

[KelRN215, BSN, RN]

Who "decided" to do this? The appropriate rate to run this infusion at would have been 200 mL/hr.

In my experience, there are times when it's appropriate to use your judgment to change the rate (patient with a history of Redman's reaction to Vanco, Resident not paying attention and just clicks buttons and orders the standard "run over 60 min". You know the patient has a history of Redman's and therefore that the infusion has to be run slower, in my hospital this was simply a standard of care and we didn't really bother calling the Resident and telling them to change the order because he probably doesn't know what Redman's is anyway) but just because the patient was elderly? Why did that lead someone to believe that taking an extra 20 min for the infusion would make a difference?

[MendedHeart]

I'm a little confused on that too, since it's going against orders?[/quote']

Our MDs dont write for IVPB rates. The pharm determines standard rate and suggests that. The IV machines have the Meds and rates pre programed as well as the unit your on so that meds can be morse specific. It really depends on what your hanging. Most things should be run on pharm.provided intervals, however, I have slowed FFP and Blood, I know thats not a PB though.

[Esme12, ASN, BSN, RN]

I agree with Kel....WHO decided this? If a patient is a fragile CHF/Pulmonary edema patient and is fluid sensitive...I could see infusing it a little slower. However then it becomes a judgement call and not a calculation.

[Esme12, ASN, BSN, RN]

Our MDs don't write for IVPB rates. The pharm determines standard rate and suggests that. The IV machines have the Meds and rates pre programed as well as the unit your on so that meds can be more specific. It really depends on what your hanging. Most things should be run on pharm.provided intervals, however, I have slowed FFP and Blood, I know that's not a PB though.

Not all facilities have IV pumps that have pre-programmed rates. There are plenty of facilities that still have standard pumps. The order stated "over one hour".

[MendedHeart]

Thats fine, just saying what we have. MDs do not ususlly write rate. Rate is not part of the order. Dose, route, frequency, medication is a complete order.