Why use Buretrols?

EricJRN, MSN, RN · Sep 4, 2006

I think they're a must, especially in the NICU. When you're in a hurry, it's surprisingly easy to accidentally press a button on the IV pump an extra time. In the event that this happens, you don't want a whole bag of IVF/med infusing before the error is detected.

gonzo1, ASN, RN · Sep 4, 2006

It took me a while to learn how to use them but now that I mastered it I love it. When used correctly completely eliminates chance of giving young one too much fluid. I would never give IV fluids to a child without using one now. Sure hope they are not obsolete.

babynurselsa, RN · Sep 4, 2006

When used properly a buretrol is a safety device in delivering IVF to the neonate and peds population.

By right I mean filling the buretrol and then CLAMPING to the bag. This way if there is a pump or programming error then you have minimized the excess fluid to the patient.

Think of it this way if a baby is only supposed to be getting say 10cc/hr and there is a malfunction of some sort then they will not get a 500/1000cc bolus. This could be catastrophic.

Jolie, BSN · Sep 4, 2006

https://allnurses.com/forums/f35/buretrol-magnesium-167269.html

The above referenced thread pertains to a different patient population (OB patients receiving MgSO4), but points out many good reasons to use buretrols.

I wouldn't hang an IV on a NICU or peds patient without one.

Gompers, BSN, RN · Sep 4, 2006

We've recently stopped using them. I hear they've decided, after much research, that the IV pumps we use are safe enough to go without. It makes us a little uncomfortable, but to be honest I've never seen an "accident" where the patient got a huge bolus whether there was a buretrol or not. Our IV pump tubing has a safety mechanism on it - the tubing is clamped as it goes into the machine. That way, when you pull the tubing out of the machine, it is still clamped and nothing gets to the baby unless you take the extra step of unclamping it.

What I wish we would do is eliminate IV pumps with hanging bags completely and run everything on syringe pumps. At least then you can see exactly how much is left in the syringe at all times, plus our "smart pumps" have parameters for things like rates/dosages and if you go outside of the normal limits it alarms to warn you before it'll let you override the system.

babynurselsa, RN · Sep 4, 2006

The only accidents I have seen Gompers is when the pump was set wrong and the baby got several hours bolus in one hour. (user error) The other problem like I previously stated was in the ER and the person did not clamp to the bag. This kinda makes the buretrol senseless don't ya think.

How the peanut? I see your ticker counting down the days....

BittyBabyGrower, MSN, RN · Sep 4, 2006

We haven't had buretrols in about 15 years. We double check all IV solution rates with another RN, so we have had no problems.

NICU Mama · Sep 4, 2006

I've worked in three different NICU's. Two of them used buretrols and one did not. I never saw an accident in the NICU not using buretrols, but I did see an accident when a buretrol was being used. The fluid was D10W with 1 unit heparin/cc and it was y'd in with TPN and the rate was suppose to be 0.5cc/hr. When the pump was checked, the rate programmed was 5cc/hr. Still a small amount, but the baby received 10 hours worth of that fluid in only one hour. It didn't result in any bad outcome, but errors can happen with and without buretrols. Most important is to be vigilent about checking your pumps hourly along with IV sites!

dawngloves, BSN, RN · Sep 5, 2006

I don't understand Buetrols either.With the pumps we use, they are obsolete. I like the idea of syringe pumps, but it's be a huge PITA with some 12 pound diabetic kid. No syringe big eough for TPN. You'd have to change it Q8h at least!

Rxlover · Sep 5, 2006

Thanks to everyone for their input. I guess I can just let my students know the Buretrol is an option but it is up to Hospital protocol and ward preference. One more question-is it always used between the pump and patient or can you just hang it alone? In my 15 years as a tech, I've never had to put meds in one, so I'm very lost concerning them. Thanks again, rxlover

Mimi2RN, ASN, RN · Sep 5, 2006

I don't understand Buetrols either.With the pumps we use, they are obsolete. I like the idea of syringe pumps, but it's be a huge PITA with some 12 pound diabetic kid. No syringe big eough for TPN. You'd have to change it Q8h at least!

We use both kinds of pumps, tubing with buratrols with the big ones or syringe pumps. The tubing we use for the syringe pumps spikes the bag and has a stopcock where the syringe attaches. You can use up to a 60ml syringe on those pumps. We just refill the syringe and clamp the tubing to the bag off while it's infusing. Really, the syringe acts like a buratrol, limiting the amount we infuse into the baby.