Roller clamp flowrate inaccuracy

Be_Moore · Jun 17, 2009

Not to mention the flow-rate is also dependant on IV bore size, positioning, and extremity positioning. A 16g in an AC can take fluid like a champ. But the more the arm bends, the more the flow rate slows until it stops.

Which is why we use IV pumps these days.

BrnEyedGirl, BSN, MSN, RN, APRN · Jun 17, 2009

Anything that is really that time sensitive should be put on a pump. I don't have the time to "reset" the flow every 30 minutes so if it really matters it goes on a pump!

sbyramRN · Jun 17, 2009

Yeah, we have a pump for everything at our hospital.

squirt2008 · Jun 17, 2009

Yikes.....flashback to nursing school 20 years ago calculating gtt rate...I thought every modern facility had pumps!

Medic09, BSN, RN, EMT-P · Jun 17, 2009

Sure we have pumps. But in the ER I don't need to use a pump for a simple fluid resusc on a basically stable patient. Setting the rate with the drip chamber is just fine. It is even, I would argue, a good idea to retain some basic skills and not have a machine do everything when not really needed. I have not found over the years that my drip rates change very much at all. Now, when carrying a patient on a wilderness rescue or moving them in and out of aircraft, I've been known to cover the roller clamp to protect it from getting bumped. But that's a different instance.

For anything time sensitive or needing accurate titrations, I use a pump. That means in the ER, I need a pump maybe a bit more than 50% of the times I do IVs.

And yes, it is kinda scary to remember doing pressors with just a 60 drop set and a watch. It worked, though; for the most part.

squirt2008 · Jun 17, 2009

Well, I certainly agree with retaining basic skills. It is SO easy to 'forget' if you don't practice those skills. WOW..sounds like you have a cool job, transporting people in the wilderness......I see you are a flight RN. Very cool. And I certainly agree there are times when a pump is not needed/available. I just always worked in ICU with pumps, so of course I had a flash back! Kinda like the ole' nursing cap!

rjflyn, ASN, RN · Jun 17, 2009

Sure we have pumps. But in the ER I don't need to use a pump for a simple fluid resusc on a basically stable patient. Setting the rate with the drip chamber is just fine. It is even, I would argue, a good idea to retain some basic skills and not have a machine do everything when not really needed. I have not found over the years that my drip rates change very much at all. Now, when carrying a patient on a wilderness rescue or moving them in and out of aircraft, I've been known to cover the roller clamp to protect it from getting bumped. But that's a different instance.
For anything time sensitive or needing accurate titrations, I use a pump. That means in the ER, I need a pump maybe a bit more than 50% of the times I do IVs.
And yes, it is kinda scary to remember doing pressors with just a 60 drop set and a watch. It worked, though; for the most part.

I couldn't agree with you more but i recently left a facility that look at it being 2009. Patient safety was number one. They have these red rules as they call them i.e. offenses one can be terminated on the first offense. In January they added not having IV's on a pump to this list. You cant eve give a NS bolus without one. I spent better parts of my afternoons and evenings having the ordery hunt down IV pumps don't you know.