Hello David, Assuming that 5 minutes have been lost to starting the IV and properly hanging the early antibiotic above the primary solutions in open bolus....
An 18 gauge PIV would work for patients under 138 lbs A 16 gauge PIV would work for patients under 264 lbs A 14 gauge PIV would work for patients under 502 lbs To deliver the required fluids in 30 minutes using a single PIV. Assuming the PIV above was put in a larger vein of the upper arm to accommodate flow. Ultrasound IV starts will help. Big needles and big veins show up better which makes connecting the two easier. The time lost from using ultrasound made up by extremely higher flow rates. The 14 gauge IV can gravity infuse a 1 liter bag in 3.6 minutes. IO needles claim 5L/hour flow rates via humerus access. Making them only applicable for patients under 183 lbs. to accomplish the recommended delivery in time. Best, Matt Reavill 815-483-5712 Sent from my iPhone > On Oct 7, 2014, at 10:44 AM, <[email protected]> wrote: > > Hello, > > I have a question about IV bolus bundle compliance. I have noted in the > 3-hour Bundle to administer 30 mL/kg Crystalloid for hypotension or Lactate > >/= 4 mmol/L and that this is over 30 minutes. My question is this, to be > complaint must the entire bolus be completed within 30 minutes? For example, > for a 100 kg patient, the total bolus would be 3000 ml over 30 minutes (6000 > ml/hr). I am trying to understand how we could meet this measure for an obese > patient population that may require > 4 Liters. Thank you for your attention > in this matter. > > Sincerely, > > > David L Threatt RN, BSN > Division Director of Clinical Informatics/EHR > HCA South Atlantic Division > 900 Island Park Dr. Suite 102 > Charleston, SC 29492 > > (t) 843-856-7959, (m) 980-230-9244 > > _______________________________________________ > Sepsisgroups mailing list > [email protected] > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
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