Titratables AKA drips Titrated medications are added to

Titratables: AKA “drips” • “Titrated medications are added to a specific volume of fluid and then adjusted to infuse at the rate at which the desired effect is obtained. ” Morris, Calculate with Confidence 1

You must consider • Compatibilities – Y-site, solution/additive – Hospital protocol • Calculations – Flow rates for maintenance fluids are ordered in m. L/hr – Anything on an infusion pump is m. L/hr. 2

Calculations • Medications (drips) are ordered in drug /hour or drug/min. • mg, mcg, units, etc. Calculate into ml/hr 3

Dr Order: Heparin 1000 units/hr IV • Must know – Amount of drug in the bag – Volume of fluid in the bag • This gives you concentration (amt of drug per 1 m. L) 4

Programming Pumps • How fast do I run the pump to deliver the right dose? • How much drug is my patient receiving? 5

Programming the Pump • Insulin drip for diabetic ketoacidosis • 100 units regular insulin in 200 ml NS • Sliding scale every 2 hours according to fingerstick BG 300 – 350 give 6 units/hr BG 250 – 299 give 4 units/hr BG 200 – 249 give 2 units/hr < 200 hold for 1 hr and recheck Q 2 h 6

Medication Protocols Standing orders • Start drip at ____ • If this happens, then do this • Check [lab] every ____ hours. 7

Infusions by Weight Drug is ordered per hour or per minute per kilogram (kg) of body weight Dr Order: Dopamine 3 mcg/kg/min (We will do the math in class) 8

Documentation • • MARs IV Flow sheets Lab flow sheets I&0 9