Why we learn to calculate drip rates

[SuesquatchRN]

When I took my clinical exam for Excelsior we had to calculate a drip rate and then set the IV to flow at the correct rate via the clamp and gravity. People have told me that it was a waste to learn, no one does that anymore, it's all pumps.

My dad is in the hospital on saline and IV abx. It's all running via gravity. The only thing via pump is his NG feed.

[MA Nurse]

When I took my clinical exam for Excelsior we had to calculate a drip rate and then set the IV to flow at the correct rate via the clamp and gravity. People have told me that it was a waste to learn, no one does that anymore, it's all pumps.

My dad is in the hospital on saline and IV abx. It's all running via gravity. The only thing via pump is his NG feed.

Personally, I think it's scary that your dad doesn't have an IV pump. The only time I've seen fluids running by gravity is when a pt. comes back from the OR, then we put the bag on a pump. The gravity method is asking for errors...JMO

[chicookie, BSN, RN]

In nursing school it was a big deal and they told it was if we were ever with out lights or in the case of an emergency.

We have our own little power plant so this hospital never loses electricity. I for one haven't used it yet and don't look forward to the day I have to.

[SuesquatchRN, BSN, RN]

Personally, I think it's scary that your dad doesn't have an IV pump. The only time I've seen fluids running by gravity is when a pt. comes back from the OR, then we put the bag on a pump. The gravity method is asking for errors...JMO

For NS and ABX?

[dawngloves, BSN, RN]

For NS and ABX?

Sure. What if dad was a CHFer and a whole liter of saline infused in him in half an hour?

It's been so long since I've hung drips to gravity, I can't remember how! Mico gtt/Macro gtt, piggybacks..Arrgghh! Just glad our hospital has a generator and the pumps have a 12 hour back up battery!

[MedSurgeMess]

When I was in NS, we had a 100 question test each semester on drips and dosage calcs, to which failure caused being dropped from the program. I'm glad I know this, as there have been times that the pharmacy has sent up an IV med with the wrong rate on it. No I don't calculate each one, only if it seems out of bounds wrong. Also, we've had pumps malfunction before, so to be able to walk in at a given time and look at the fluids and know if it is obviously flowing too fast/slow is our job. I teach clinicals and this is the exact reason I give when the groans come up. I know so many of us feel it is almost an obsolete skill, but in places that are devastated by disaster or small facilities that don't have enough pumps to go around, it is anything but obsolete. Just like percussion in an assessment.....but that would be a whole other post....

[pagandeva2000, LPN]

You are sooo funny. In fact you sounded like me at one point in time!! Here's the deal.....hospitals are now turning to plum pumps for calculations in order to avoid IV medication/drip errors. The pump will tell the nurse if an "unsafe" dosage is programmed into the pump prior to administration. However, it is still imperative that you know how to do it for the Boards and in real life! In reality, there will always be someone there to help you with a given calculation. But is important that you know HOW to do that particular calculation because it will be part of your practice at some point. Yes, Pharmacy can help you. Yes, another nurse who is more seasoned than you can help you....etc. But ultimately, you SHOULD know how to calculate so you can check things for yourself.

Here's a good example.....In the hospital you will see heparin drips all the time! It is the MD's responsibility to figure out how many units/hour that patient will receive based on the patient's diagnosis and weight. It is the pharmacy's responsibility to see that the correct amount of heparin goes into each bag for that patient. It is YOUR responsibility to see that the MD came to that dosage correctly. Did he know how much the patient weighed at the time he prescribed the drip, or did he just guess? (Yes, I said "guess"). Sometimes, doctors are as busy as nurses. Did I just say that??!! Anyway, orders are written in a hurry sometimes, and despite popular opinion.....doctors make mistakes!!! So, here's just a glimpse of why you should know how to manually calculate when necessary.

Don't fret...when in doubt just ask!

Kali, RN, MSN

That is true; we had a patient die this way...the doctor ordered too much heparin drip for a patient and the nurse didn't calculate-she just took his word.