Published Jun 24, 2009
When you run a PCA at what rate do you run your IV fluid? Just would like some opinions and rationals, please
If they don't have maintenance fluids running, we run the fluids at 20ml/hr to keep the IV patent.
FireStarterRN, BSN, RN
The PCA orders will call for a TKO rate. Everything should be on your order sheet. The TKO rate is in order to dilute the narcotic and keep it from sitting in the vein in between doses. It acts as a saline flush.
We run our pca pumps TKO unless there is an order to have a set rate of maintenance fluids running.
As others have posted, my facility runs fluids at TKO unless there is a physician's order to the contrary, such as NS @ 100, etc.
IVRUS, BSN, RN
This really depends on whether your patient is receiving a "basal" rate and "bolus" capabilities, or just a basal, or just bolus!
A basal rate for a PCA will deliver a steady, consistant flow rate to the pt.
A pump set to only deliver a Bolus' at prescribed intervals, will need that IV mainline at a KVO rate. It can be set at various rates ( usually 5-10mls/hr ).
However when a pt is receiving a basal rate, no other fluids are needed as the flow of the medication being constantly delivered is enough to keep the catheter open. This flow rate may be as small as 0.2cc/hr.
Bolus only capabilities start and stop, and therefore need maintenance fluids.
Hope this helps!
We run ours at the post operative rate for the night they come back from the OR then in the morning we can decrease it to TKVO depending on if the patient is tolerating their analgesia and not experiencing lots of nausea and vomitting...We have standing orders that we can decrease their rate as we like..We can also discontinue their PCA without a Drs order depending on our judgement.
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