TKO: to keep open

[babaloo, BSN]

Can someone explain what this means and what the purpose of having an IV fluid run TKO is?

[FlorenceFrightengale]

Hi babaloo!

Some institutions call it "KVO," or "keep vein open," and it's a rate of 20 mL or 30 mL an hour - 0.9 Normal Saline Solution is used.

I usually only use this when I'm running an antibiotic on a syringe, a PCA pump, or Y'd with a Potassium or Magnesium Rider.

In the case of the PCA, the pain medicine is not going fast enough to ensure the IV line does not clot off - so it needs some "help" from a running drip.

As far as the antibiotic or the Riders, these medicines are harsh on the veins and sometimes cause burning. The patient feels better if these medications are diluted with saline.

I hope I helped! I just woke up and haven't had my coffee yet! Welcome to the board, I'm new also! My name is Brittany.

[iluvivt, BSN, RN]

Technically you do not need a TKO or KVO rate to keep it patent. If that were true that locked venous access devices would always clot off and that is not the case. A KVO or TKO rate just provides an added convenience for the patient and the nurse in addition to some IVFs. There are many factors that cause venous irritation and that has a lot to do with the ph and osmolarity of the drug and how far away those numbers are from normal blood. The quality of the vein its location and the size of the cannula are also factors.The goal is to get as much hemodilution as possible when infusing irritating medications, There are also a lot of medications that are inherently irritating no matter what you do!

[eatmysoxRN, ASN, RN]

I like kvo fluids when a patient was a terrible stick... In the instance that it did clot off, reaccess would be difficult.

On INTs I try to flush twice a shift. KVO fluids are less for hydration and more for maintaining the site.

~ No One Can Make You Feel Inferior Without Your Consent -Eleanor Roosevelt ~

[Esme12, ASN, BSN, RN]

Welcome to AN! The largest online nursing community!

TKO...to keep vein open. Difficult sticks this helps in retaining the IV site by preventing clots and like ilutit says with PCA pumps to allow a way for the drug to be delivered at a steady rate and minimal fluid

[Music in My Heart]

I have no hard data to back it up but my experience and reason indicate that it remains easier to draw blood through a saline lock which has been maintained with TKO fluids than simply locked off.

Also, since liter bags are overfilled by 100 cc or so, switching the pump to TKO keeps the line clear of air until I know that I don't need to hang addition fluids or piggy backs.

[brithoover]

I use TKVO with pts with central lines that don't have fluids running but need IV antibiotics. This makes it so you don't have to access and reaccess the line every time you need to hang the ax.

[sunnyharbor]

This explanation was very helpful! Thank you!