Sun 7 May, 2006 05:59 am
iv infusion rate
what are the risks of too fast infusion rates? and how fast is too fast? Hope to be enlightened...thanks!
too fast infusions
The major risk of too fast infusions is pulmonary edema--fluid overload. What is too fast depends on what you are giving. Some IVP medications have rates of infusion. Vancomycin or Gentamycin given too fast can cause hearing loss. Any infusing IV is too fast if given faster than the doctor orders. Burn patients require fluid resussicitation and require very rapid infusions of IV fluids thru several large IV sites. Heart patients, the elderly, patients with rapid heart rates or hypertension or CHF are prone to pulmonary edema and need to be watched whatever the rate, the more of those diseases in one patient, the more dangerous fluids are.
Thank you for the info. It cleared my confusion. I was arguing with a senior colleague the other day about infusing 1L Ringers acetate in two hours to an elderly demented patient. Doctor's order 1L/24hours. We agreed to follow the doctor in the end. Agains thanks for the reply.
well remember as long as you have RN behind your name, you have the right to refuse to do anything you are uncomfortable with--however you should be able to justify why you are uncomfortable. You have a right to question orders and call doctors for clarification if you cannot read their orders. If you go to court, you have to answer for what you do. I have refused to do things I am uncomfortable with and offered the other person the right to do the procedure. Remember doctors are not always right either, but if you do something they ask and it is wrong, you are the one who gets into trouble. Protect your lisence at all times.
Helpfulll comparision on what you are trying to do. Your order is 1L/24 hours. Ok, if the order were 1/L in 10 hrs then it would be 100cc hr. right? if it were 1L in 20 it would be 50cc hr right? Well 1 cup is 240cc. So roughly speaking the pt is taking in 4 cups of liquid total, or less than 1/4 cup an hour. This is a very slow rate almost a KVO. Most pts would be able to take this no problem. However 1L/2 hours is 500cc hour. That is faster than free flow in most instances. That is a very fast rate. The kind of thing you might use in an emergy for volum depleation with active bleeding. Becasue of their bodies inability to process that fluid quickly many elderly pt's would go into fluid overload. A good example of controling this is an order that reads give 1 unit of blood over 4 hours and lasix 40 IV after infusion. A unit of blood is roughly 400cc. The Dr. knows this, if you give it over 4 hours, the speed will be approx 100cc hr. Most pts are going to be able to handle that. Thus the Dr. knows he will not be causing overload and yet he will achieve homeostasis. Remember, you almost never see IV speeds of greater than 150cc hr. out on the floor. (Or even in the ER) There are certain exceptions, such as IV previcid is 400cc hr, but the volume is only 50cc so it is in in 15 min. When you see IV's of large volume going faster than that you need to check your mar and your orders. Generally the speed that an IV is to be administered at is writen on the bag. Good luck