When do you personally use an IV pump?

[1fastRN]

ER nurses are notorious for giving fluids wide open or on mini med tubing. I thought it would be cool to compile a list of the meds we use a pump for our categories.

No pump:

Ns on a young generally healthy person

NS wide open for emergent situations

Emergency blood admin (life or death)

Some antibiotics

Pump:

Blood

Emergency drips

Sedatives

Any fluids for pt at risk for fluid overload chf, dialysis pts, elderly)

Strict I/o pt (pre op, etc)

Generally anyone I anticipate going to ICU

Electrolytes

Narcotic drips (duh)

What do you consider to be a drug or antibiotic that MUST be on a pump?

[psu_213, BSN, RN]

Basically any bolus of fluid that is flowing well on its own, I go with no pump. I will also "free flow" stuff that does not have a specific rate/infusion time specified. For example, benadryl or decadron (I've learned by bad experience that those shouldn't be pushed...or not pushed to quickly--it's just easier to put them in a minibag and piggyback them).

Our policy specifies the infusion time for ABX (for instance, 30 min. for 4.5 g of zosyn--although I might free flow this one if we we short on pumps, which occurs from time to time; 2 hours for a 1 g of vanco, etc.) so I put them on a pump. And then of course there is the stuff that has to be, no exceptions, on a pump--KCl, NTG, dilt, heparin, etc.

[zmansc, ASN, RN]

Main Job, we have one or more pumps in every room, I put everything on a pump unless it needs to be put in via pressure bag, i.e. blood/fluids that need a pressure bag to get in now.

PRN job, only a couple of pumps in the facility, pumps are used sparingly only when counting drips isn't sufficient or when every time I check on the pt the fluids have stopped because they are bending their arm, etc.

Personally, in ideal situation I'd go with the abundance of pumps, I find it makes the fluid administration more accurate and reliable.