Question about infusion rate?

MedicalLPN, LPN · Nov 8, 2007

Hmm... not really sure what you're talking about, where I work the only meds we infuse that are in prefilled syringes are Dilaudid and Morphine that we use for PCA's. We give Pepcid, Protonix, etc IVP although I did do a Protonix drip on a pt once which was kinda unsual. Some more info would be great.

ukstudent · Nov 8, 2007

1) 10 ml in 1 minute. 10 x 60 = 600 ml/hr

2) 10 ml in 2 minutes. 10 x 30 = 300 ml/hr

3) 30 ml in 30 minutes. 30 x 2 = 60 ml/hr.

mstaylor · Nov 9, 2007

Thank you UKstudent, that is what I came up with when I did the math. For the first question of 10ml in one minute...different nurses told me to set the rate at 75ml/hr or 100ml per hour or 150ml per hour. It was my first two days on the floor and already quite overwhelmed, I thought I was going crazy when they told me these off the wall rates. Again, thank you!

AnnieOaklyRN, BSN, RN, EMT-P · Nov 9, 2007

MS Taylor,

Are you a CNA/LNA setting these up or are you a nursing student when you are doing this. If you are a CNA or LNA tell them you cannot do this as you are not lisenced to do so and doing so is beyond your scope of practice. If you are a nursing student disregard that, but make sure you are using a nursing instructor for guidance.

Sweetooth

mstaylor · Nov 9, 2007

I have been an RN for 10 years with almost no experience in using Infusion Pumps for the last 10 years. I have just started my orientation on the med-surg floor. Everything I am learning is new to me. I am quite overwhelmed but I am excited and eager to learn this speciality of medical-surgical nursing.

Daytonite, BSN, RN · Nov 10, 2007

Whenever you are in doubt, you should always be able to call the pharmacist to verify an infusion rate.

As for determining infusion rates. . .most pumps are always set at cc's (mL's) per hour, so. . .

1) Prefilled syringe 10 ml to infuse over one minute. (I can't remember the med on this one) What is the rate set at?

10 mL/1 minute

(dose desired)

x 60 minutes/1 hour

(conversion factor) =

600 mL/hour

(infusion rate)

2) Pepsid 20mg in prefilled syringe of 10 ml, infuse over 2 minutes. Rate?

10 mL/2 minutes

(dose desired)

x 60 minutes/1 hour

(conversion factor)

=

300 mL/hour

(infusion rate)

3) Prefilled syringe 30 ml, infuse over 30 minutes. Rate?

30 mL/30 minutes

(dose desired)

x 60 minutes/1 hour

(conversion factor)

=

60 mL/hour

(infusion rate)

mstaylor · Nov 11, 2007

yes, thank you daytonite.....i came up with those same answers when i did the math in my head prior to giving the meds. but my preceptors told me different answers such as for the 1st question, 75ml/hr or 150ml/hr.

i am glad i am not thinking crazy. i am having a hard enough time learning how to work on the med surg floor.

veronica butterfly, ADN, RN · Nov 12, 2007

We don't do this on the med/surg floor where I work. Peds has special pumps that they load syringes in. Do you put the syringe on the port that you normally would hook up a piggyback to??

However, on our pumps we can let the pump do the math. Arrow down past the rates per hours, plug in the VTBI (volume to be infused) (10 cc in your case) and then arrow down to DURATION (1 minute in your case). Our pump will then automatically determine the rate. Maybe yours does too??

However, sounds like this isn't the safest way to do this. Anything you run as a piggyback should come from pharmacy with the rate to run printed right on the bag. Sounds like you might be setting yourself up for a med error. Don't go along with the crowd if your gut is telling you otherwise!

Nrs_angie, BSN, RN · Nov 15, 2007

Hello,

I know this post is a little old.. but I just logged on today for the first in a long time.

The hospital where I work (I am off on leave right now ) but we used pre-filled syringes for many types of Antibiotics all the time. It was very common. Cephepime is one that stands out in my mind... as well as Ancef. There were others, that I just cant remember right now.

Fortunatelly we had something called a BARD pump which used time in minutes as the infusion setting. For example a 10 ml syringe of cephepime would need 30 minutes to infuse. So you just set the pump for 30 min. Pharmacy had done research on all the meds which were infused this way, and they determined a specific amount of time which was "safe" to infuse the med. Some meds needed only 10 minutes... but typically it was 30 min.

I just dont see why you wouldn't "push" the meds which are to infuse over 1 minute or two minutes. It seems silly? Am I missing something here?

As for the other RN's telling you to set the pumps at a slower rate such as 175 ml/hr, I can only assume that maybe because they feel the med was irritating to the patient's vein. If you find out, let us know.

mstaylor · Nov 16, 2007

it happened again to me today. i had a 10ml syringe of pepsid to give over 2 minutes (5ml per minute). i went into the room to give it iv push, but my preceptor said, "oh no, just put it in the infusion pump!" i don't understand why. also, i have been reading up on different iv meds so i know the common ones as to how much time it needs to be iv pushed. most are anywhere from 1 minute to 5 minutes. of course i am trying to be a good nurse to time my iv pushes (a couple of preceptors let me iv push instead of putting it in the infusion pump). these preceptors said to me to just push it in quicker, there is no time to wait the full 1 or 2 minutes cause you need to get to the next patient. yes, i feel like i am going crazy in my head with all this. now i am looking at the clock half way through the day to see how much time i have left to go home.

Nrs_angie, BSN, RN · Nov 16, 2007

it happened again to me today. i had a 10ml syringe of pepsid to give over 2 minutes (5ml per minute). i went into the room to give it iv push, but my preceptor said, "oh no, just put it in the infusion pump!" i don't understand why. also, i have been reading up on different iv meds so i know the common ones as to how much time it needs to be iv pushed. most are anywhere from 1 minute to 5 minutes. of course i am trying to be a good nurse to time my iv pushes (a couple of preceptors let me iv push instead of putting it in the infusion pump). these preceptors said to me to just push it in quicker, there is no time to wait the full 1 or 2 minutes cause you need to get to the next patient. yes, i feel like i am going crazy in my head with all this. now i am looking at the clock half way through the day to see how much time i have left to go home.

ahhh this is pretty much what i was assuming when i read your first post... now it is more clear.... the only reason they are telling you to put it on the pump is because you don't have time to stand there for 5 minutes slowly pushing a med... the pump will do the work for you and accurately.... thats all.

in the same way that we used the bard pump for antibiotics in prefilled syringes that came up from pharmacy... we could also use the pump for iv push meds that we filled ourselves... a common one was lopressor iv which needed to be pushed over 5 minutes... no need to stand there... the machine would do the work for you... especially handy when the pt is getting multiple doses of lopressor throughout the shift.

next time you are unsure why these nurses tell you to do something a certain way that you've never done before... say it simply this way...

"im just curious... in the hospital where i worked before (nursing home, clinic, ect), we always just pushed the med. is there another reason why you want me to put it on the pump?"

if they wont explain their rationale... then they should be written up with the supervisor.