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We have the capability and the authority, but in practice it seldom happens. The math is too complex, due to the way we mix our drips. One notable exception is propofol, which we use a lot in our unit (and yes, PICU nurses are covered to give it and to monitor infusions of it in our facility) because we use pure drug, the concentration of which is 10 mg/ml, so the math is dead simple. But even with propofol, some nurses choose to draw up their bolus doses from the bottle. Not this nurse!
We do it. Our sedation drips are standard concentrations (usually 1:1 for versed, 10:1 for fentanyl, etc). Our orders are for a continuous infusion with a seperate order for bolus, if needed. The bolus orders are writte, as far as I can remember, in both dose and how much in mL that would be off the pump.
Whatever the case, we have another RN check when we set our pumps and change syringes or settings. Most of our pumps have built in bolus buttons, so we just set it and can hit it when we need a bolus. We've never had a problem with it.
Yes we do. I think the most common one would be Fentanyl. We have a bolus button on the syrine pump and can watch the numbers tick up as long as its held down. Of course we have to have this witnessed by another RN and charted.
Now we did just get new syringe pumps and I've not used it to do it, I'm not even sure how or if it's an option on them.
RNNPICU, BSN, RN
1,310 Posts
Hi. I am working on a project right now regarding bolusing sedation meds of the syringe pump. I was curious how many other PICUs have this practice. Thanks in advance