Prescribing IV Infusions

CWFS

Problem areas

bull bullCalculating infusion rates

bull bullCompleting the form

bull bullAwareness of appropriate volumes and dose

bull bullCompatibilities and the BNF

Prescribing infusions

bull bullPrescribe on correct chartbull Once only section of prescription chart for

injections (loading doses IV bolus doses) bull Drug kardex for multiple bolusesbull IV chart for infusionsbull bullInfusion fluid and strengthbull No abbreviationsbull What is in the bag before you add anything

Volume

bull Number of mls before you add anything

NB for continuous infusion max 2-3L per day

bullAdditive and dose

The drug you are adding and the total number of mg or units to add to the bag

bullRate in mlhour

Injectionsinfusions

bull bullIV = fast injectionbolusbull Usually just a few millilitresbull bullSlow IV = over 5-10 minutesbull Usually lt10ml unless by syringe driverbull bullInfusion = gt100ml over at least 20 minutesbull Rate has to be monitored

Compatibilities

bull bullBNF Appendix 6 Intravenous additives

bull Not exhaustive

bull Ask Pharmacy

bull bullCheck appendix carefully as not all drugs are compatible with sodium chloride 09

Practice 1

bull bullMrBen is a 37 year old man admitted with a paracetamol overdose His plasma-paracetamol concentration (mmollitre) indicates that he requires acetylcysteine He weighs 67kg

bull Prescribe on an intravenous prescribing sheet the acetylcysteine regimen that he requires so that it can be administered

bull bullBNF Acetylcysteine bull Adult and Child initially 150mgkg over 15 minutes then

50mgkg over 4 hours then 100mgkg over 16 hours

bull Dilute requisite dose in glucose 5 as follows Initially 200ml given over 15 minutes then 500ml over 4 hours then 1 litre over 16 hours

Practice 1 -Answer

bull bullStep 1ndashcalculate the dose over the period bull of time you require (weight 67kg) bull 150mgkg over 15 minutes = 10050mgbull 50mgkg over 4 hours = 3350mgbull 100mgkg over 16 hours = 6700mgbull bullStep 2ndashfollow BNF instruction for dilutionbull initially 200ml given over 15 minutes bull then 500ml over 4 hours bull then 1 litre over 16 hours

Practice 1 -Answer

bull bullStep 3ndashcalculate the ratebull Rate = Volume Timebull bull10050mg in 200ml dextrose 5 over 15 minbull bull3350mg in 500ml dextrose 5over 4 hours bull Rate = 500ml4hours = 125mlhourbull bull6700mg in 1 litre dextrose 5over 16 hoursbull 1l = 1000ml bull Rate = 1000ml16hours = 625mlhour

IV practice 2

bull bullMrsSmith is a 28 year old epileptic who you wish to initiate on sodium valproate She is 50kg and currently unable to swallow

bull bullBNF No 53 Sodium valproatebull 1048707Initiation of valproate therapy by intravenous injection (over

3ndash5 minutes) 400-800mg (up to 10mgkg) followed by a continuous intravenous infusion up to max 25g daily

bull bullYou wish to give her an initial loading dose of 4mgkg followed by an intravenous infusion of 16g over 24 hours

bull bullPrescribe the required loading dose and intravenous infusion that she requires

IV practice 2 -answer

bull bullStep 1ndashcalculate the initiation dosebull 4mgkg = 4x50 = 200mg over 5 minutes

bull Step 2 ndashWhat infusion fluid and volume do you require

ndash BNF Glucose 5 or sodium chloride 09 any suitable volume

ndash Pick one Sodium chloride 09 500ml

bull bullStep 3ndashConvert to mlhour

bull 500ml over 24 hours

bull = 208mlhour

bull 5Prescribe it

bull Sodium chloride 09 500ml

bull Sodium valproate 16g

bull Rate 208mlhr

IV practice 3

bull bullMr Taylor is a 45 year old man requiring inotropic support after infarction He weighs 60 kg

bull bullThe consultant says he needs to be prescribed dobutamine 25microgramkgmin at a concentration of 500microgramsml and give it in glucose 5 500ml

bull bullPrescribe the IV prescription that he requires

IV practice 3 -answer

bull bullStep 1 ndashcalculate total amount of dobutamine in bag

bull 500ml at 500mcgml ndash = 250000micrograms =250mg

bull bullStep 2 -calculate the dose over the period of bull time you requirebull 25mcgkgminbull 60kg

bull 25x60x60 bull = 9000mcghour = 9mghour

IV practice 3 -answer

bull Step 3 ndashcalculate the ratebull 9mghourbull 500mcgml

bull Rate = 9000bull 500 bull = 18mlhour

bull 4Prescribe it

bull Glucose 5 500ml

bull Dobutamine 250mg

bull Rate 18mlhr

Self-check for IV prescriptions

bull bullCorrect chartbull bullCorrect drugbull bullAmount of drug in infusionbull bullVolume and name of diluentbull bullRate andor duration of administrationbull bullRoute of administrationbull bullDated and signed

Calculations

bull bullRead the question carefullybull bullExtract all information from questionbull Which information is givenbull What are you asked to calculatebull bullGet as much info as possible from BNFbull (dosage administration etc)bull Appendix 6 Intravenous additivesbull Express question as an equation

Safety Check

bull Consider asking somebody else to check your work especially if tired stressed

• Prescribing IV Infusions
• Problem areas
• Prescribing infusions
• Volume
• Injectionsinfusions
• Compatibilities
• Practice 1
• Practice 1 -Answer
• Slide 9
• IV practice 2
• IV practice 2 -answer
• Slide 12
• IV practice 3
• IV practice 3 -answer
• IV practice 3 -answer
• Slide 16
• Self-check for IV prescriptions
• Calculations
• Safety Check

Problem areas

bull bullCalculating infusion rates

bull bullCompleting the form

bull bullAwareness of appropriate volumes and dose

bull bullCompatibilities and the BNF

Prescribing infusions

bull bullPrescribe on correct chartbull Once only section of prescription chart for

injections (loading doses IV bolus doses) bull Drug kardex for multiple bolusesbull IV chart for infusionsbull bullInfusion fluid and strengthbull No abbreviationsbull What is in the bag before you add anything

Volume

bull Number of mls before you add anything

NB for continuous infusion max 2-3L per day

bullAdditive and dose

The drug you are adding and the total number of mg or units to add to the bag

bullRate in mlhour

Injectionsinfusions

bull bullIV = fast injectionbolusbull Usually just a few millilitresbull bullSlow IV = over 5-10 minutesbull Usually lt10ml unless by syringe driverbull bullInfusion = gt100ml over at least 20 minutesbull Rate has to be monitored

Compatibilities

bull bullBNF Appendix 6 Intravenous additives

bull Not exhaustive

bull Ask Pharmacy

bull bullCheck appendix carefully as not all drugs are compatible with sodium chloride 09

Practice 1

bull bullMrBen is a 37 year old man admitted with a paracetamol overdose His plasma-paracetamol concentration (mmollitre) indicates that he requires acetylcysteine He weighs 67kg

bull Prescribe on an intravenous prescribing sheet the acetylcysteine regimen that he requires so that it can be administered

bull bullBNF Acetylcysteine bull Adult and Child initially 150mgkg over 15 minutes then

50mgkg over 4 hours then 100mgkg over 16 hours

bull Dilute requisite dose in glucose 5 as follows Initially 200ml given over 15 minutes then 500ml over 4 hours then 1 litre over 16 hours

Practice 1 -Answer

bull bullStep 1ndashcalculate the dose over the period bull of time you require (weight 67kg) bull 150mgkg over 15 minutes = 10050mgbull 50mgkg over 4 hours = 3350mgbull 100mgkg over 16 hours = 6700mgbull bullStep 2ndashfollow BNF instruction for dilutionbull initially 200ml given over 15 minutes bull then 500ml over 4 hours bull then 1 litre over 16 hours

Practice 1 -Answer

bull bullStep 3ndashcalculate the ratebull Rate = Volume Timebull bull10050mg in 200ml dextrose 5 over 15 minbull bull3350mg in 500ml dextrose 5over 4 hours bull Rate = 500ml4hours = 125mlhourbull bull6700mg in 1 litre dextrose 5over 16 hoursbull 1l = 1000ml bull Rate = 1000ml16hours = 625mlhour

IV practice 2

bull bullMrsSmith is a 28 year old epileptic who you wish to initiate on sodium valproate She is 50kg and currently unable to swallow

bull bullBNF No 53 Sodium valproatebull 1048707Initiation of valproate therapy by intravenous injection (over

3ndash5 minutes) 400-800mg (up to 10mgkg) followed by a continuous intravenous infusion up to max 25g daily

bull bullYou wish to give her an initial loading dose of 4mgkg followed by an intravenous infusion of 16g over 24 hours

bull bullPrescribe the required loading dose and intravenous infusion that she requires

IV practice 2 -answer

bull bullStep 1ndashcalculate the initiation dosebull 4mgkg = 4x50 = 200mg over 5 minutes

bull Step 2 ndashWhat infusion fluid and volume do you require

ndash BNF Glucose 5 or sodium chloride 09 any suitable volume

ndash Pick one Sodium chloride 09 500ml

bull bullStep 3ndashConvert to mlhour

bull 500ml over 24 hours

bull = 208mlhour

bull 5Prescribe it

bull Sodium chloride 09 500ml

bull Sodium valproate 16g

bull Rate 208mlhr

IV practice 3

bull bullMr Taylor is a 45 year old man requiring inotropic support after infarction He weighs 60 kg

bull bullThe consultant says he needs to be prescribed dobutamine 25microgramkgmin at a concentration of 500microgramsml and give it in glucose 5 500ml

bull bullPrescribe the IV prescription that he requires

IV practice 3 -answer

bull bullStep 1 ndashcalculate total amount of dobutamine in bag

bull 500ml at 500mcgml ndash = 250000micrograms =250mg

bull bullStep 2 -calculate the dose over the period of bull time you requirebull 25mcgkgminbull 60kg

bull 25x60x60 bull = 9000mcghour = 9mghour

IV practice 3 -answer

bull Step 3 ndashcalculate the ratebull 9mghourbull 500mcgml

bull Rate = 9000bull 500 bull = 18mlhour

bull 4Prescribe it

bull Glucose 5 500ml

bull Dobutamine 250mg

bull Rate 18mlhr

Self-check for IV prescriptions

bull bullCorrect chartbull bullCorrect drugbull bullAmount of drug in infusionbull bullVolume and name of diluentbull bullRate andor duration of administrationbull bullRoute of administrationbull bullDated and signed

Calculations

bull bullRead the question carefullybull bullExtract all information from questionbull Which information is givenbull What are you asked to calculatebull bullGet as much info as possible from BNFbull (dosage administration etc)bull Appendix 6 Intravenous additivesbull Express question as an equation

Safety Check

bull Consider asking somebody else to check your work especially if tired stressed

• Prescribing IV Infusions
• Problem areas
• Prescribing infusions
• Volume
• Injectionsinfusions
• Compatibilities
• Practice 1
• Practice 1 -Answer
• Slide 9
• IV practice 2
• IV practice 2 -answer
• Slide 12
• IV practice 3
• IV practice 3 -answer
• IV practice 3 -answer
• Slide 16
• Self-check for IV prescriptions
• Calculations
• Safety Check

Prescribing infusions

bull bullPrescribe on correct chartbull Once only section of prescription chart for

injections (loading doses IV bolus doses) bull Drug kardex for multiple bolusesbull IV chart for infusionsbull bullInfusion fluid and strengthbull No abbreviationsbull What is in the bag before you add anything

Volume

bull Number of mls before you add anything

NB for continuous infusion max 2-3L per day

bullAdditive and dose

The drug you are adding and the total number of mg or units to add to the bag

bullRate in mlhour

Injectionsinfusions

bull bullIV = fast injectionbolusbull Usually just a few millilitresbull bullSlow IV = over 5-10 minutesbull Usually lt10ml unless by syringe driverbull bullInfusion = gt100ml over at least 20 minutesbull Rate has to be monitored

Compatibilities

bull bullBNF Appendix 6 Intravenous additives

bull Not exhaustive

bull Ask Pharmacy

bull bullCheck appendix carefully as not all drugs are compatible with sodium chloride 09

Practice 1

bull bullMrBen is a 37 year old man admitted with a paracetamol overdose His plasma-paracetamol concentration (mmollitre) indicates that he requires acetylcysteine He weighs 67kg

bull Prescribe on an intravenous prescribing sheet the acetylcysteine regimen that he requires so that it can be administered

bull bullBNF Acetylcysteine bull Adult and Child initially 150mgkg over 15 minutes then

50mgkg over 4 hours then 100mgkg over 16 hours

bull Dilute requisite dose in glucose 5 as follows Initially 200ml given over 15 minutes then 500ml over 4 hours then 1 litre over 16 hours

Practice 1 -Answer

bull bullStep 1ndashcalculate the dose over the period bull of time you require (weight 67kg) bull 150mgkg over 15 minutes = 10050mgbull 50mgkg over 4 hours = 3350mgbull 100mgkg over 16 hours = 6700mgbull bullStep 2ndashfollow BNF instruction for dilutionbull initially 200ml given over 15 minutes bull then 500ml over 4 hours bull then 1 litre over 16 hours

Practice 1 -Answer

bull bullStep 3ndashcalculate the ratebull Rate = Volume Timebull bull10050mg in 200ml dextrose 5 over 15 minbull bull3350mg in 500ml dextrose 5over 4 hours bull Rate = 500ml4hours = 125mlhourbull bull6700mg in 1 litre dextrose 5over 16 hoursbull 1l = 1000ml bull Rate = 1000ml16hours = 625mlhour

IV practice 2

bull bullMrsSmith is a 28 year old epileptic who you wish to initiate on sodium valproate She is 50kg and currently unable to swallow

bull bullBNF No 53 Sodium valproatebull 1048707Initiation of valproate therapy by intravenous injection (over

3ndash5 minutes) 400-800mg (up to 10mgkg) followed by a continuous intravenous infusion up to max 25g daily

bull bullYou wish to give her an initial loading dose of 4mgkg followed by an intravenous infusion of 16g over 24 hours

bull bullPrescribe the required loading dose and intravenous infusion that she requires

IV practice 2 -answer

bull bullStep 1ndashcalculate the initiation dosebull 4mgkg = 4x50 = 200mg over 5 minutes

bull Step 2 ndashWhat infusion fluid and volume do you require

ndash BNF Glucose 5 or sodium chloride 09 any suitable volume

ndash Pick one Sodium chloride 09 500ml

bull bullStep 3ndashConvert to mlhour

bull 500ml over 24 hours

bull = 208mlhour

bull 5Prescribe it

bull Sodium chloride 09 500ml

bull Sodium valproate 16g

bull Rate 208mlhr

IV practice 3

bull bullMr Taylor is a 45 year old man requiring inotropic support after infarction He weighs 60 kg

bull bullThe consultant says he needs to be prescribed dobutamine 25microgramkgmin at a concentration of 500microgramsml and give it in glucose 5 500ml

bull bullPrescribe the IV prescription that he requires

IV practice 3 -answer

bull bullStep 1 ndashcalculate total amount of dobutamine in bag

bull 500ml at 500mcgml ndash = 250000micrograms =250mg

bull bullStep 2 -calculate the dose over the period of bull time you requirebull 25mcgkgminbull 60kg

bull 25x60x60 bull = 9000mcghour = 9mghour

IV practice 3 -answer

bull Step 3 ndashcalculate the ratebull 9mghourbull 500mcgml

bull Rate = 9000bull 500 bull = 18mlhour

bull 4Prescribe it

bull Glucose 5 500ml

bull Dobutamine 250mg

bull Rate 18mlhr

Self-check for IV prescriptions

bull bullCorrect chartbull bullCorrect drugbull bullAmount of drug in infusionbull bullVolume and name of diluentbull bullRate andor duration of administrationbull bullRoute of administrationbull bullDated and signed

Calculations

bull bullRead the question carefullybull bullExtract all information from questionbull Which information is givenbull What are you asked to calculatebull bullGet as much info as possible from BNFbull (dosage administration etc)bull Appendix 6 Intravenous additivesbull Express question as an equation

Safety Check

bull Consider asking somebody else to check your work especially if tired stressed

• Prescribing IV Infusions
• Problem areas
• Prescribing infusions
• Volume
• Injectionsinfusions
• Compatibilities
• Practice 1
• Practice 1 -Answer
• Slide 9
• IV practice 2
• IV practice 2 -answer
• Slide 12
• IV practice 3
• IV practice 3 -answer
• IV practice 3 -answer
• Slide 16
• Self-check for IV prescriptions
• Calculations
• Safety Check

Volume

bull Number of mls before you add anything

NB for continuous infusion max 2-3L per day

bullAdditive and dose

The drug you are adding and the total number of mg or units to add to the bag

bullRate in mlhour

Injectionsinfusions

bull bullIV = fast injectionbolusbull Usually just a few millilitresbull bullSlow IV = over 5-10 minutesbull Usually lt10ml unless by syringe driverbull bullInfusion = gt100ml over at least 20 minutesbull Rate has to be monitored

Compatibilities

bull bullBNF Appendix 6 Intravenous additives

bull Not exhaustive

bull Ask Pharmacy

bull bullCheck appendix carefully as not all drugs are compatible with sodium chloride 09

Practice 1

bull bullMrBen is a 37 year old man admitted with a paracetamol overdose His plasma-paracetamol concentration (mmollitre) indicates that he requires acetylcysteine He weighs 67kg

bull Prescribe on an intravenous prescribing sheet the acetylcysteine regimen that he requires so that it can be administered

bull bullBNF Acetylcysteine bull Adult and Child initially 150mgkg over 15 minutes then

50mgkg over 4 hours then 100mgkg over 16 hours

bull Dilute requisite dose in glucose 5 as follows Initially 200ml given over 15 minutes then 500ml over 4 hours then 1 litre over 16 hours

Practice 1 -Answer

bull bullStep 1ndashcalculate the dose over the period bull of time you require (weight 67kg) bull 150mgkg over 15 minutes = 10050mgbull 50mgkg over 4 hours = 3350mgbull 100mgkg over 16 hours = 6700mgbull bullStep 2ndashfollow BNF instruction for dilutionbull initially 200ml given over 15 minutes bull then 500ml over 4 hours bull then 1 litre over 16 hours

Practice 1 -Answer

bull bullStep 3ndashcalculate the ratebull Rate = Volume Timebull bull10050mg in 200ml dextrose 5 over 15 minbull bull3350mg in 500ml dextrose 5over 4 hours bull Rate = 500ml4hours = 125mlhourbull bull6700mg in 1 litre dextrose 5over 16 hoursbull 1l = 1000ml bull Rate = 1000ml16hours = 625mlhour

IV practice 2

bull bullMrsSmith is a 28 year old epileptic who you wish to initiate on sodium valproate She is 50kg and currently unable to swallow

bull bullBNF No 53 Sodium valproatebull 1048707Initiation of valproate therapy by intravenous injection (over

3ndash5 minutes) 400-800mg (up to 10mgkg) followed by a continuous intravenous infusion up to max 25g daily

bull bullYou wish to give her an initial loading dose of 4mgkg followed by an intravenous infusion of 16g over 24 hours

bull bullPrescribe the required loading dose and intravenous infusion that she requires

IV practice 2 -answer

bull bullStep 1ndashcalculate the initiation dosebull 4mgkg = 4x50 = 200mg over 5 minutes

bull Step 2 ndashWhat infusion fluid and volume do you require

ndash BNF Glucose 5 or sodium chloride 09 any suitable volume

ndash Pick one Sodium chloride 09 500ml

bull bullStep 3ndashConvert to mlhour

bull 500ml over 24 hours

bull = 208mlhour

bull 5Prescribe it

bull Sodium chloride 09 500ml

bull Sodium valproate 16g

bull Rate 208mlhr

IV practice 3

bull bullMr Taylor is a 45 year old man requiring inotropic support after infarction He weighs 60 kg

bull bullThe consultant says he needs to be prescribed dobutamine 25microgramkgmin at a concentration of 500microgramsml and give it in glucose 5 500ml

bull bullPrescribe the IV prescription that he requires

IV practice 3 -answer

bull bullStep 1 ndashcalculate total amount of dobutamine in bag

bull 500ml at 500mcgml ndash = 250000micrograms =250mg

bull bullStep 2 -calculate the dose over the period of bull time you requirebull 25mcgkgminbull 60kg

bull 25x60x60 bull = 9000mcghour = 9mghour

IV practice 3 -answer

bull Step 3 ndashcalculate the ratebull 9mghourbull 500mcgml

bull Rate = 9000bull 500 bull = 18mlhour

bull 4Prescribe it

bull Glucose 5 500ml

bull Dobutamine 250mg

bull Rate 18mlhr

Self-check for IV prescriptions

bull bullCorrect chartbull bullCorrect drugbull bullAmount of drug in infusionbull bullVolume and name of diluentbull bullRate andor duration of administrationbull bullRoute of administrationbull bullDated and signed

Calculations

bull bullRead the question carefullybull bullExtract all information from questionbull Which information is givenbull What are you asked to calculatebull bullGet as much info as possible from BNFbull (dosage administration etc)bull Appendix 6 Intravenous additivesbull Express question as an equation

Safety Check

bull Consider asking somebody else to check your work especially if tired stressed

• Prescribing IV Infusions
• Problem areas
• Prescribing infusions
• Volume
• Injectionsinfusions
• Compatibilities
• Practice 1
• Practice 1 -Answer
• Slide 9
• IV practice 2
• IV practice 2 -answer
• Slide 12
• IV practice 3
• IV practice 3 -answer
• IV practice 3 -answer
• Slide 16
• Self-check for IV prescriptions
• Calculations
• Safety Check

Injectionsinfusions

bull bullIV = fast injectionbolusbull Usually just a few millilitresbull bullSlow IV = over 5-10 minutesbull Usually lt10ml unless by syringe driverbull bullInfusion = gt100ml over at least 20 minutesbull Rate has to be monitored

Compatibilities

bull bullBNF Appendix 6 Intravenous additives

bull Not exhaustive

bull Ask Pharmacy

bull bullCheck appendix carefully as not all drugs are compatible with sodium chloride 09

Practice 1

bull bullMrBen is a 37 year old man admitted with a paracetamol overdose His plasma-paracetamol concentration (mmollitre) indicates that he requires acetylcysteine He weighs 67kg

bull Prescribe on an intravenous prescribing sheet the acetylcysteine regimen that he requires so that it can be administered

bull bullBNF Acetylcysteine bull Adult and Child initially 150mgkg over 15 minutes then

50mgkg over 4 hours then 100mgkg over 16 hours

bull Dilute requisite dose in glucose 5 as follows Initially 200ml given over 15 minutes then 500ml over 4 hours then 1 litre over 16 hours

Practice 1 -Answer

bull bullStep 1ndashcalculate the dose over the period bull of time you require (weight 67kg) bull 150mgkg over 15 minutes = 10050mgbull 50mgkg over 4 hours = 3350mgbull 100mgkg over 16 hours = 6700mgbull bullStep 2ndashfollow BNF instruction for dilutionbull initially 200ml given over 15 minutes bull then 500ml over 4 hours bull then 1 litre over 16 hours

Practice 1 -Answer

bull bullStep 3ndashcalculate the ratebull Rate = Volume Timebull bull10050mg in 200ml dextrose 5 over 15 minbull bull3350mg in 500ml dextrose 5over 4 hours bull Rate = 500ml4hours = 125mlhourbull bull6700mg in 1 litre dextrose 5over 16 hoursbull 1l = 1000ml bull Rate = 1000ml16hours = 625mlhour

IV practice 2

bull bullMrsSmith is a 28 year old epileptic who you wish to initiate on sodium valproate She is 50kg and currently unable to swallow

bull bullBNF No 53 Sodium valproatebull 1048707Initiation of valproate therapy by intravenous injection (over

3ndash5 minutes) 400-800mg (up to 10mgkg) followed by a continuous intravenous infusion up to max 25g daily

bull bullYou wish to give her an initial loading dose of 4mgkg followed by an intravenous infusion of 16g over 24 hours

bull bullPrescribe the required loading dose and intravenous infusion that she requires

IV practice 2 -answer

bull bullStep 1ndashcalculate the initiation dosebull 4mgkg = 4x50 = 200mg over 5 minutes

bull Step 2 ndashWhat infusion fluid and volume do you require

ndash BNF Glucose 5 or sodium chloride 09 any suitable volume

ndash Pick one Sodium chloride 09 500ml

bull bullStep 3ndashConvert to mlhour

bull 500ml over 24 hours

bull = 208mlhour

bull 5Prescribe it

bull Sodium chloride 09 500ml

bull Sodium valproate 16g

bull Rate 208mlhr

IV practice 3

bull bullMr Taylor is a 45 year old man requiring inotropic support after infarction He weighs 60 kg

bull bullThe consultant says he needs to be prescribed dobutamine 25microgramkgmin at a concentration of 500microgramsml and give it in glucose 5 500ml

bull bullPrescribe the IV prescription that he requires

IV practice 3 -answer

bull bullStep 1 ndashcalculate total amount of dobutamine in bag

bull 500ml at 500mcgml ndash = 250000micrograms =250mg

bull bullStep 2 -calculate the dose over the period of bull time you requirebull 25mcgkgminbull 60kg

bull 25x60x60 bull = 9000mcghour = 9mghour

IV practice 3 -answer

bull Step 3 ndashcalculate the ratebull 9mghourbull 500mcgml

bull Rate = 9000bull 500 bull = 18mlhour

bull 4Prescribe it

bull Glucose 5 500ml

bull Dobutamine 250mg

bull Rate 18mlhr

Self-check for IV prescriptions

bull bullCorrect chartbull bullCorrect drugbull bullAmount of drug in infusionbull bullVolume and name of diluentbull bullRate andor duration of administrationbull bullRoute of administrationbull bullDated and signed

Calculations

bull bullRead the question carefullybull bullExtract all information from questionbull Which information is givenbull What are you asked to calculatebull bullGet as much info as possible from BNFbull (dosage administration etc)bull Appendix 6 Intravenous additivesbull Express question as an equation

Safety Check

bull Consider asking somebody else to check your work especially if tired stressed

• Prescribing IV Infusions
• Problem areas
• Prescribing infusions
• Volume
• Injectionsinfusions
• Compatibilities
• Practice 1
• Practice 1 -Answer
• Slide 9
• IV practice 2
• IV practice 2 -answer
• Slide 12
• IV practice 3
• IV practice 3 -answer
• IV practice 3 -answer
• Slide 16
• Self-check for IV prescriptions
• Calculations
• Safety Check

Compatibilities

bull bullBNF Appendix 6 Intravenous additives

bull Not exhaustive

bull Ask Pharmacy

bull bullCheck appendix carefully as not all drugs are compatible with sodium chloride 09

Practice 1

bull bullMrBen is a 37 year old man admitted with a paracetamol overdose His plasma-paracetamol concentration (mmollitre) indicates that he requires acetylcysteine He weighs 67kg

bull Prescribe on an intravenous prescribing sheet the acetylcysteine regimen that he requires so that it can be administered

bull bullBNF Acetylcysteine bull Adult and Child initially 150mgkg over 15 minutes then

50mgkg over 4 hours then 100mgkg over 16 hours

bull Dilute requisite dose in glucose 5 as follows Initially 200ml given over 15 minutes then 500ml over 4 hours then 1 litre over 16 hours

Practice 1 -Answer

bull bullStep 1ndashcalculate the dose over the period bull of time you require (weight 67kg) bull 150mgkg over 15 minutes = 10050mgbull 50mgkg over 4 hours = 3350mgbull 100mgkg over 16 hours = 6700mgbull bullStep 2ndashfollow BNF instruction for dilutionbull initially 200ml given over 15 minutes bull then 500ml over 4 hours bull then 1 litre over 16 hours

Practice 1 -Answer

bull bullStep 3ndashcalculate the ratebull Rate = Volume Timebull bull10050mg in 200ml dextrose 5 over 15 minbull bull3350mg in 500ml dextrose 5over 4 hours bull Rate = 500ml4hours = 125mlhourbull bull6700mg in 1 litre dextrose 5over 16 hoursbull 1l = 1000ml bull Rate = 1000ml16hours = 625mlhour

IV practice 2

bull bullMrsSmith is a 28 year old epileptic who you wish to initiate on sodium valproate She is 50kg and currently unable to swallow

bull bullBNF No 53 Sodium valproatebull 1048707Initiation of valproate therapy by intravenous injection (over

3ndash5 minutes) 400-800mg (up to 10mgkg) followed by a continuous intravenous infusion up to max 25g daily

bull bullYou wish to give her an initial loading dose of 4mgkg followed by an intravenous infusion of 16g over 24 hours

bull bullPrescribe the required loading dose and intravenous infusion that she requires

IV practice 2 -answer

bull bullStep 1ndashcalculate the initiation dosebull 4mgkg = 4x50 = 200mg over 5 minutes

bull Step 2 ndashWhat infusion fluid and volume do you require

ndash BNF Glucose 5 or sodium chloride 09 any suitable volume

ndash Pick one Sodium chloride 09 500ml

bull bullStep 3ndashConvert to mlhour

bull 500ml over 24 hours

bull = 208mlhour

bull 5Prescribe it

bull Sodium chloride 09 500ml

bull Sodium valproate 16g

bull Rate 208mlhr

IV practice 3

bull bullMr Taylor is a 45 year old man requiring inotropic support after infarction He weighs 60 kg

bull bullThe consultant says he needs to be prescribed dobutamine 25microgramkgmin at a concentration of 500microgramsml and give it in glucose 5 500ml

bull bullPrescribe the IV prescription that he requires

IV practice 3 -answer

bull bullStep 1 ndashcalculate total amount of dobutamine in bag

bull 500ml at 500mcgml ndash = 250000micrograms =250mg

bull bullStep 2 -calculate the dose over the period of bull time you requirebull 25mcgkgminbull 60kg

bull 25x60x60 bull = 9000mcghour = 9mghour

IV practice 3 -answer

bull Step 3 ndashcalculate the ratebull 9mghourbull 500mcgml

bull Rate = 9000bull 500 bull = 18mlhour

bull 4Prescribe it

bull Glucose 5 500ml

bull Dobutamine 250mg

bull Rate 18mlhr

Self-check for IV prescriptions

bull bullCorrect chartbull bullCorrect drugbull bullAmount of drug in infusionbull bullVolume and name of diluentbull bullRate andor duration of administrationbull bullRoute of administrationbull bullDated and signed

Calculations

bull bullRead the question carefullybull bullExtract all information from questionbull Which information is givenbull What are you asked to calculatebull bullGet as much info as possible from BNFbull (dosage administration etc)bull Appendix 6 Intravenous additivesbull Express question as an equation

Safety Check

bull Consider asking somebody else to check your work especially if tired stressed

• Prescribing IV Infusions
• Problem areas
• Prescribing infusions
• Volume
• Injectionsinfusions
• Compatibilities
• Practice 1
• Practice 1 -Answer
• Slide 9
• IV practice 2
• IV practice 2 -answer
• Slide 12
• IV practice 3
• IV practice 3 -answer
• IV practice 3 -answer
• Slide 16
• Self-check for IV prescriptions
• Calculations
• Safety Check

Practice 1

bull bullMrBen is a 37 year old man admitted with a paracetamol overdose His plasma-paracetamol concentration (mmollitre) indicates that he requires acetylcysteine He weighs 67kg

bull Prescribe on an intravenous prescribing sheet the acetylcysteine regimen that he requires so that it can be administered

bull bullBNF Acetylcysteine bull Adult and Child initially 150mgkg over 15 minutes then

50mgkg over 4 hours then 100mgkg over 16 hours

bull Dilute requisite dose in glucose 5 as follows Initially 200ml given over 15 minutes then 500ml over 4 hours then 1 litre over 16 hours

Practice 1 -Answer

bull bullStep 1ndashcalculate the dose over the period bull of time you require (weight 67kg) bull 150mgkg over 15 minutes = 10050mgbull 50mgkg over 4 hours = 3350mgbull 100mgkg over 16 hours = 6700mgbull bullStep 2ndashfollow BNF instruction for dilutionbull initially 200ml given over 15 minutes bull then 500ml over 4 hours bull then 1 litre over 16 hours

Practice 1 -Answer

bull bullStep 3ndashcalculate the ratebull Rate = Volume Timebull bull10050mg in 200ml dextrose 5 over 15 minbull bull3350mg in 500ml dextrose 5over 4 hours bull Rate = 500ml4hours = 125mlhourbull bull6700mg in 1 litre dextrose 5over 16 hoursbull 1l = 1000ml bull Rate = 1000ml16hours = 625mlhour

IV practice 2

bull bullMrsSmith is a 28 year old epileptic who you wish to initiate on sodium valproate She is 50kg and currently unable to swallow

bull bullBNF No 53 Sodium valproatebull 1048707Initiation of valproate therapy by intravenous injection (over

3ndash5 minutes) 400-800mg (up to 10mgkg) followed by a continuous intravenous infusion up to max 25g daily

bull bullYou wish to give her an initial loading dose of 4mgkg followed by an intravenous infusion of 16g over 24 hours

bull bullPrescribe the required loading dose and intravenous infusion that she requires

IV practice 2 -answer

bull bullStep 1ndashcalculate the initiation dosebull 4mgkg = 4x50 = 200mg over 5 minutes

bull Step 2 ndashWhat infusion fluid and volume do you require

ndash BNF Glucose 5 or sodium chloride 09 any suitable volume

ndash Pick one Sodium chloride 09 500ml

bull bullStep 3ndashConvert to mlhour

bull 500ml over 24 hours

bull = 208mlhour

bull 5Prescribe it

bull Sodium chloride 09 500ml

bull Sodium valproate 16g

bull Rate 208mlhr

IV practice 3

bull bullMr Taylor is a 45 year old man requiring inotropic support after infarction He weighs 60 kg

bull bullThe consultant says he needs to be prescribed dobutamine 25microgramkgmin at a concentration of 500microgramsml and give it in glucose 5 500ml

bull bullPrescribe the IV prescription that he requires

IV practice 3 -answer

bull bullStep 1 ndashcalculate total amount of dobutamine in bag

bull 500ml at 500mcgml ndash = 250000micrograms =250mg

bull bullStep 2 -calculate the dose over the period of bull time you requirebull 25mcgkgminbull 60kg

bull 25x60x60 bull = 9000mcghour = 9mghour

IV practice 3 -answer

bull Step 3 ndashcalculate the ratebull 9mghourbull 500mcgml

bull Rate = 9000bull 500 bull = 18mlhour

bull 4Prescribe it

bull Glucose 5 500ml

bull Dobutamine 250mg

bull Rate 18mlhr

Self-check for IV prescriptions

bull bullCorrect chartbull bullCorrect drugbull bullAmount of drug in infusionbull bullVolume and name of diluentbull bullRate andor duration of administrationbull bullRoute of administrationbull bullDated and signed

Calculations

bull bullRead the question carefullybull bullExtract all information from questionbull Which information is givenbull What are you asked to calculatebull bullGet as much info as possible from BNFbull (dosage administration etc)bull Appendix 6 Intravenous additivesbull Express question as an equation

Safety Check

bull Consider asking somebody else to check your work especially if tired stressed

• Prescribing IV Infusions
• Problem areas
• Prescribing infusions
• Volume
• Injectionsinfusions
• Compatibilities
• Practice 1
• Practice 1 -Answer
• Slide 9
• IV practice 2
• IV practice 2 -answer
• Slide 12
• IV practice 3
• IV practice 3 -answer
• IV practice 3 -answer
• Slide 16
• Self-check for IV prescriptions
• Calculations
• Safety Check

Practice 1 -Answer

bull bullStep 1ndashcalculate the dose over the period bull of time you require (weight 67kg) bull 150mgkg over 15 minutes = 10050mgbull 50mgkg over 4 hours = 3350mgbull 100mgkg over 16 hours = 6700mgbull bullStep 2ndashfollow BNF instruction for dilutionbull initially 200ml given over 15 minutes bull then 500ml over 4 hours bull then 1 litre over 16 hours

Practice 1 -Answer

bull bullStep 3ndashcalculate the ratebull Rate = Volume Timebull bull10050mg in 200ml dextrose 5 over 15 minbull bull3350mg in 500ml dextrose 5over 4 hours bull Rate = 500ml4hours = 125mlhourbull bull6700mg in 1 litre dextrose 5over 16 hoursbull 1l = 1000ml bull Rate = 1000ml16hours = 625mlhour

IV practice 2

bull bullMrsSmith is a 28 year old epileptic who you wish to initiate on sodium valproate She is 50kg and currently unable to swallow

bull bullBNF No 53 Sodium valproatebull 1048707Initiation of valproate therapy by intravenous injection (over

3ndash5 minutes) 400-800mg (up to 10mgkg) followed by a continuous intravenous infusion up to max 25g daily

bull bullYou wish to give her an initial loading dose of 4mgkg followed by an intravenous infusion of 16g over 24 hours

bull bullPrescribe the required loading dose and intravenous infusion that she requires

IV practice 2 -answer

bull bullStep 1ndashcalculate the initiation dosebull 4mgkg = 4x50 = 200mg over 5 minutes

bull Step 2 ndashWhat infusion fluid and volume do you require

ndash BNF Glucose 5 or sodium chloride 09 any suitable volume

ndash Pick one Sodium chloride 09 500ml

bull bullStep 3ndashConvert to mlhour

bull 500ml over 24 hours

bull = 208mlhour

bull 5Prescribe it

bull Sodium chloride 09 500ml

bull Sodium valproate 16g

bull Rate 208mlhr

IV practice 3

bull bullMr Taylor is a 45 year old man requiring inotropic support after infarction He weighs 60 kg

bull bullThe consultant says he needs to be prescribed dobutamine 25microgramkgmin at a concentration of 500microgramsml and give it in glucose 5 500ml

bull bullPrescribe the IV prescription that he requires

IV practice 3 -answer

bull bullStep 1 ndashcalculate total amount of dobutamine in bag

bull 500ml at 500mcgml ndash = 250000micrograms =250mg

bull bullStep 2 -calculate the dose over the period of bull time you requirebull 25mcgkgminbull 60kg

bull 25x60x60 bull = 9000mcghour = 9mghour

IV practice 3 -answer

bull Step 3 ndashcalculate the ratebull 9mghourbull 500mcgml

bull Rate = 9000bull 500 bull = 18mlhour

bull 4Prescribe it

bull Glucose 5 500ml

bull Dobutamine 250mg

bull Rate 18mlhr

Self-check for IV prescriptions

bull bullCorrect chartbull bullCorrect drugbull bullAmount of drug in infusionbull bullVolume and name of diluentbull bullRate andor duration of administrationbull bullRoute of administrationbull bullDated and signed

Calculations

bull bullRead the question carefullybull bullExtract all information from questionbull Which information is givenbull What are you asked to calculatebull bullGet as much info as possible from BNFbull (dosage administration etc)bull Appendix 6 Intravenous additivesbull Express question as an equation

Safety Check

bull Consider asking somebody else to check your work especially if tired stressed

• Prescribing IV Infusions
• Problem areas
• Prescribing infusions
• Volume
• Injectionsinfusions
• Compatibilities
• Practice 1
• Practice 1 -Answer
• Slide 9
• IV practice 2
• IV practice 2 -answer
• Slide 12
• IV practice 3
• IV practice 3 -answer
• IV practice 3 -answer
• Slide 16
• Self-check for IV prescriptions
• Calculations
• Safety Check

Practice 1 -Answer

bull bullStep 3ndashcalculate the ratebull Rate = Volume Timebull bull10050mg in 200ml dextrose 5 over 15 minbull bull3350mg in 500ml dextrose 5over 4 hours bull Rate = 500ml4hours = 125mlhourbull bull6700mg in 1 litre dextrose 5over 16 hoursbull 1l = 1000ml bull Rate = 1000ml16hours = 625mlhour

IV practice 2

bull bullMrsSmith is a 28 year old epileptic who you wish to initiate on sodium valproate She is 50kg and currently unable to swallow

bull bullBNF No 53 Sodium valproatebull 1048707Initiation of valproate therapy by intravenous injection (over

3ndash5 minutes) 400-800mg (up to 10mgkg) followed by a continuous intravenous infusion up to max 25g daily

bull bullYou wish to give her an initial loading dose of 4mgkg followed by an intravenous infusion of 16g over 24 hours

bull bullPrescribe the required loading dose and intravenous infusion that she requires

IV practice 2 -answer

bull bullStep 1ndashcalculate the initiation dosebull 4mgkg = 4x50 = 200mg over 5 minutes

bull Step 2 ndashWhat infusion fluid and volume do you require

ndash BNF Glucose 5 or sodium chloride 09 any suitable volume

ndash Pick one Sodium chloride 09 500ml

bull bullStep 3ndashConvert to mlhour

bull 500ml over 24 hours

bull = 208mlhour

bull 5Prescribe it

bull Sodium chloride 09 500ml

bull Sodium valproate 16g

bull Rate 208mlhr

IV practice 3

bull bullMr Taylor is a 45 year old man requiring inotropic support after infarction He weighs 60 kg

bull bullThe consultant says he needs to be prescribed dobutamine 25microgramkgmin at a concentration of 500microgramsml and give it in glucose 5 500ml

bull bullPrescribe the IV prescription that he requires

IV practice 3 -answer

bull bullStep 1 ndashcalculate total amount of dobutamine in bag

bull 500ml at 500mcgml ndash = 250000micrograms =250mg

bull bullStep 2 -calculate the dose over the period of bull time you requirebull 25mcgkgminbull 60kg

bull 25x60x60 bull = 9000mcghour = 9mghour

IV practice 3 -answer

bull Step 3 ndashcalculate the ratebull 9mghourbull 500mcgml

bull Rate = 9000bull 500 bull = 18mlhour

bull 4Prescribe it

bull Glucose 5 500ml

bull Dobutamine 250mg

bull Rate 18mlhr

Self-check for IV prescriptions

bull bullCorrect chartbull bullCorrect drugbull bullAmount of drug in infusionbull bullVolume and name of diluentbull bullRate andor duration of administrationbull bullRoute of administrationbull bullDated and signed

Calculations

bull bullRead the question carefullybull bullExtract all information from questionbull Which information is givenbull What are you asked to calculatebull bullGet as much info as possible from BNFbull (dosage administration etc)bull Appendix 6 Intravenous additivesbull Express question as an equation

Safety Check

bull Consider asking somebody else to check your work especially if tired stressed

• Prescribing IV Infusions
• Problem areas
• Prescribing infusions
• Volume
• Injectionsinfusions
• Compatibilities
• Practice 1
• Practice 1 -Answer
• Slide 9
• IV practice 2
• IV practice 2 -answer
• Slide 12
• IV practice 3
• IV practice 3 -answer
• IV practice 3 -answer
• Slide 16
• Self-check for IV prescriptions
• Calculations
• Safety Check

IV practice 2

bull bullMrsSmith is a 28 year old epileptic who you wish to initiate on sodium valproate She is 50kg and currently unable to swallow

bull bullBNF No 53 Sodium valproatebull 1048707Initiation of valproate therapy by intravenous injection (over

3ndash5 minutes) 400-800mg (up to 10mgkg) followed by a continuous intravenous infusion up to max 25g daily

bull bullYou wish to give her an initial loading dose of 4mgkg followed by an intravenous infusion of 16g over 24 hours

bull bullPrescribe the required loading dose and intravenous infusion that she requires

IV practice 2 -answer

bull bullStep 1ndashcalculate the initiation dosebull 4mgkg = 4x50 = 200mg over 5 minutes

bull Step 2 ndashWhat infusion fluid and volume do you require

ndash BNF Glucose 5 or sodium chloride 09 any suitable volume

ndash Pick one Sodium chloride 09 500ml

bull bullStep 3ndashConvert to mlhour

bull 500ml over 24 hours

bull = 208mlhour

bull 5Prescribe it

bull Sodium chloride 09 500ml

bull Sodium valproate 16g

bull Rate 208mlhr

IV practice 3

bull bullMr Taylor is a 45 year old man requiring inotropic support after infarction He weighs 60 kg

bull bullThe consultant says he needs to be prescribed dobutamine 25microgramkgmin at a concentration of 500microgramsml and give it in glucose 5 500ml

bull bullPrescribe the IV prescription that he requires

IV practice 3 -answer

bull bullStep 1 ndashcalculate total amount of dobutamine in bag

bull 500ml at 500mcgml ndash = 250000micrograms =250mg

bull bullStep 2 -calculate the dose over the period of bull time you requirebull 25mcgkgminbull 60kg

bull 25x60x60 bull = 9000mcghour = 9mghour

IV practice 3 -answer

bull Step 3 ndashcalculate the ratebull 9mghourbull 500mcgml

bull Rate = 9000bull 500 bull = 18mlhour

bull 4Prescribe it

bull Glucose 5 500ml

bull Dobutamine 250mg

bull Rate 18mlhr

Self-check for IV prescriptions

bull bullCorrect chartbull bullCorrect drugbull bullAmount of drug in infusionbull bullVolume and name of diluentbull bullRate andor duration of administrationbull bullRoute of administrationbull bullDated and signed

Calculations

bull bullRead the question carefullybull bullExtract all information from questionbull Which information is givenbull What are you asked to calculatebull bullGet as much info as possible from BNFbull (dosage administration etc)bull Appendix 6 Intravenous additivesbull Express question as an equation

Safety Check

bull Consider asking somebody else to check your work especially if tired stressed

• Prescribing IV Infusions
• Problem areas
• Prescribing infusions
• Volume
• Injectionsinfusions
• Compatibilities
• Practice 1
• Practice 1 -Answer
• Slide 9
• IV practice 2
• IV practice 2 -answer
• Slide 12
• IV practice 3
• IV practice 3 -answer
• IV practice 3 -answer
• Slide 16
• Self-check for IV prescriptions
• Calculations
• Safety Check

IV practice 2 -answer

bull bullStep 1ndashcalculate the initiation dosebull 4mgkg = 4x50 = 200mg over 5 minutes

bull Step 2 ndashWhat infusion fluid and volume do you require

ndash BNF Glucose 5 or sodium chloride 09 any suitable volume

ndash Pick one Sodium chloride 09 500ml

bull bullStep 3ndashConvert to mlhour

bull 500ml over 24 hours

bull = 208mlhour

bull 5Prescribe it

bull Sodium chloride 09 500ml

bull Sodium valproate 16g

bull Rate 208mlhr

IV practice 3

bull bullMr Taylor is a 45 year old man requiring inotropic support after infarction He weighs 60 kg

bull bullThe consultant says he needs to be prescribed dobutamine 25microgramkgmin at a concentration of 500microgramsml and give it in glucose 5 500ml

bull bullPrescribe the IV prescription that he requires

IV practice 3 -answer

bull bullStep 1 ndashcalculate total amount of dobutamine in bag

bull 500ml at 500mcgml ndash = 250000micrograms =250mg

bull bullStep 2 -calculate the dose over the period of bull time you requirebull 25mcgkgminbull 60kg

bull 25x60x60 bull = 9000mcghour = 9mghour

IV practice 3 -answer

bull Step 3 ndashcalculate the ratebull 9mghourbull 500mcgml

bull Rate = 9000bull 500 bull = 18mlhour

bull 4Prescribe it

bull Glucose 5 500ml

bull Dobutamine 250mg

bull Rate 18mlhr

Self-check for IV prescriptions

bull bullCorrect chartbull bullCorrect drugbull bullAmount of drug in infusionbull bullVolume and name of diluentbull bullRate andor duration of administrationbull bullRoute of administrationbull bullDated and signed

Calculations

bull bullRead the question carefullybull bullExtract all information from questionbull Which information is givenbull What are you asked to calculatebull bullGet as much info as possible from BNFbull (dosage administration etc)bull Appendix 6 Intravenous additivesbull Express question as an equation

Safety Check

bull Consider asking somebody else to check your work especially if tired stressed

• Prescribing IV Infusions
• Problem areas
• Prescribing infusions
• Volume
• Injectionsinfusions
• Compatibilities
• Practice 1
• Practice 1 -Answer
• Slide 9
• IV practice 2
• IV practice 2 -answer
• Slide 12
• IV practice 3
• IV practice 3 -answer
• IV practice 3 -answer
• Slide 16
• Self-check for IV prescriptions
• Calculations
• Safety Check

bull bullStep 3ndashConvert to mlhour

bull 500ml over 24 hours

bull = 208mlhour

bull 5Prescribe it

bull Sodium chloride 09 500ml

bull Sodium valproate 16g

bull Rate 208mlhr

IV practice 3

bull bullMr Taylor is a 45 year old man requiring inotropic support after infarction He weighs 60 kg

bull bullThe consultant says he needs to be prescribed dobutamine 25microgramkgmin at a concentration of 500microgramsml and give it in glucose 5 500ml

bull bullPrescribe the IV prescription that he requires

IV practice 3 -answer

bull bullStep 1 ndashcalculate total amount of dobutamine in bag

bull 500ml at 500mcgml ndash = 250000micrograms =250mg

bull bullStep 2 -calculate the dose over the period of bull time you requirebull 25mcgkgminbull 60kg

bull 25x60x60 bull = 9000mcghour = 9mghour

IV practice 3 -answer

bull Step 3 ndashcalculate the ratebull 9mghourbull 500mcgml

bull Rate = 9000bull 500 bull = 18mlhour

bull 4Prescribe it

bull Glucose 5 500ml

bull Dobutamine 250mg

bull Rate 18mlhr

Self-check for IV prescriptions

bull bullCorrect chartbull bullCorrect drugbull bullAmount of drug in infusionbull bullVolume and name of diluentbull bullRate andor duration of administrationbull bullRoute of administrationbull bullDated and signed

Calculations

bull bullRead the question carefullybull bullExtract all information from questionbull Which information is givenbull What are you asked to calculatebull bullGet as much info as possible from BNFbull (dosage administration etc)bull Appendix 6 Intravenous additivesbull Express question as an equation

Safety Check

bull Consider asking somebody else to check your work especially if tired stressed

• Prescribing IV Infusions
• Problem areas
• Prescribing infusions
• Volume
• Injectionsinfusions
• Compatibilities
• Practice 1
• Practice 1 -Answer
• Slide 9
• IV practice 2
• IV practice 2 -answer
• Slide 12
• IV practice 3
• IV practice 3 -answer
• IV practice 3 -answer
• Slide 16
• Self-check for IV prescriptions
• Calculations
• Safety Check

IV practice 3

bull bullMr Taylor is a 45 year old man requiring inotropic support after infarction He weighs 60 kg

bull bullThe consultant says he needs to be prescribed dobutamine 25microgramkgmin at a concentration of 500microgramsml and give it in glucose 5 500ml

bull bullPrescribe the IV prescription that he requires

IV practice 3 -answer

bull bullStep 1 ndashcalculate total amount of dobutamine in bag

bull 500ml at 500mcgml ndash = 250000micrograms =250mg

bull bullStep 2 -calculate the dose over the period of bull time you requirebull 25mcgkgminbull 60kg

bull 25x60x60 bull = 9000mcghour = 9mghour

IV practice 3 -answer

bull Step 3 ndashcalculate the ratebull 9mghourbull 500mcgml

bull Rate = 9000bull 500 bull = 18mlhour

bull 4Prescribe it

bull Glucose 5 500ml

bull Dobutamine 250mg

bull Rate 18mlhr

Self-check for IV prescriptions

bull bullCorrect chartbull bullCorrect drugbull bullAmount of drug in infusionbull bullVolume and name of diluentbull bullRate andor duration of administrationbull bullRoute of administrationbull bullDated and signed

Calculations

bull bullRead the question carefullybull bullExtract all information from questionbull Which information is givenbull What are you asked to calculatebull bullGet as much info as possible from BNFbull (dosage administration etc)bull Appendix 6 Intravenous additivesbull Express question as an equation

Safety Check

bull Consider asking somebody else to check your work especially if tired stressed

• Prescribing IV Infusions
• Problem areas
• Prescribing infusions
• Volume
• Injectionsinfusions
• Compatibilities
• Practice 1
• Practice 1 -Answer
• Slide 9
• IV practice 2
• IV practice 2 -answer
• Slide 12
• IV practice 3
• IV practice 3 -answer
• IV practice 3 -answer
• Slide 16
• Self-check for IV prescriptions
• Calculations
• Safety Check

IV practice 3 -answer

bull bullStep 1 ndashcalculate total amount of dobutamine in bag

bull 500ml at 500mcgml ndash = 250000micrograms =250mg

bull bullStep 2 -calculate the dose over the period of bull time you requirebull 25mcgkgminbull 60kg

bull 25x60x60 bull = 9000mcghour = 9mghour

IV practice 3 -answer

bull Step 3 ndashcalculate the ratebull 9mghourbull 500mcgml

bull Rate = 9000bull 500 bull = 18mlhour

bull 4Prescribe it

bull Glucose 5 500ml

bull Dobutamine 250mg

bull Rate 18mlhr

Self-check for IV prescriptions

bull bullCorrect chartbull bullCorrect drugbull bullAmount of drug in infusionbull bullVolume and name of diluentbull bullRate andor duration of administrationbull bullRoute of administrationbull bullDated and signed

Calculations

bull bullRead the question carefullybull bullExtract all information from questionbull Which information is givenbull What are you asked to calculatebull bullGet as much info as possible from BNFbull (dosage administration etc)bull Appendix 6 Intravenous additivesbull Express question as an equation

Safety Check

bull Consider asking somebody else to check your work especially if tired stressed

• Prescribing IV Infusions
• Problem areas
• Prescribing infusions
• Volume
• Injectionsinfusions
• Compatibilities
• Practice 1
• Practice 1 -Answer
• Slide 9
• IV practice 2
• IV practice 2 -answer
• Slide 12
• IV practice 3
• IV practice 3 -answer
• IV practice 3 -answer
• Slide 16
• Self-check for IV prescriptions
• Calculations
• Safety Check

IV practice 3 -answer

bull Step 3 ndashcalculate the ratebull 9mghourbull 500mcgml

bull Rate = 9000bull 500 bull = 18mlhour

bull 4Prescribe it

bull Glucose 5 500ml

bull Dobutamine 250mg

bull Rate 18mlhr

Self-check for IV prescriptions

bull bullCorrect chartbull bullCorrect drugbull bullAmount of drug in infusionbull bullVolume and name of diluentbull bullRate andor duration of administrationbull bullRoute of administrationbull bullDated and signed

Calculations

bull bullRead the question carefullybull bullExtract all information from questionbull Which information is givenbull What are you asked to calculatebull bullGet as much info as possible from BNFbull (dosage administration etc)bull Appendix 6 Intravenous additivesbull Express question as an equation

Safety Check

bull Consider asking somebody else to check your work especially if tired stressed

• Prescribing IV Infusions
• Problem areas
• Prescribing infusions
• Volume
• Injectionsinfusions
• Compatibilities
• Practice 1
• Practice 1 -Answer
• Slide 9
• IV practice 2
• IV practice 2 -answer
• Slide 12
• IV practice 3
• IV practice 3 -answer
• IV practice 3 -answer
• Slide 16
• Self-check for IV prescriptions
• Calculations
• Safety Check

bull 4Prescribe it

bull Glucose 5 500ml

bull Dobutamine 250mg

bull Rate 18mlhr

Self-check for IV prescriptions

bull bullCorrect chartbull bullCorrect drugbull bullAmount of drug in infusionbull bullVolume and name of diluentbull bullRate andor duration of administrationbull bullRoute of administrationbull bullDated and signed

Calculations

bull bullRead the question carefullybull bullExtract all information from questionbull Which information is givenbull What are you asked to calculatebull bullGet as much info as possible from BNFbull (dosage administration etc)bull Appendix 6 Intravenous additivesbull Express question as an equation

Safety Check

bull Consider asking somebody else to check your work especially if tired stressed

• Prescribing IV Infusions
• Problem areas
• Prescribing infusions
• Volume
• Injectionsinfusions
• Compatibilities
• Practice 1
• Practice 1 -Answer
• Slide 9
• IV practice 2
• IV practice 2 -answer
• Slide 12
• IV practice 3
• IV practice 3 -answer
• IV practice 3 -answer
• Slide 16
• Self-check for IV prescriptions
• Calculations
• Safety Check

Self-check for IV prescriptions

bull bullCorrect chartbull bullCorrect drugbull bullAmount of drug in infusionbull bullVolume and name of diluentbull bullRate andor duration of administrationbull bullRoute of administrationbull bullDated and signed

Calculations

bull bullRead the question carefullybull bullExtract all information from questionbull Which information is givenbull What are you asked to calculatebull bullGet as much info as possible from BNFbull (dosage administration etc)bull Appendix 6 Intravenous additivesbull Express question as an equation

Safety Check

bull Consider asking somebody else to check your work especially if tired stressed

• Prescribing IV Infusions
• Problem areas
• Prescribing infusions
• Volume
• Injectionsinfusions
• Compatibilities
• Practice 1
• Practice 1 -Answer
• Slide 9
• IV practice 2
• IV practice 2 -answer
• Slide 12
• IV practice 3
• IV practice 3 -answer
• IV practice 3 -answer
• Slide 16
• Self-check for IV prescriptions
• Calculations
• Safety Check

Calculations

bull bullRead the question carefullybull bullExtract all information from questionbull Which information is givenbull What are you asked to calculatebull bullGet as much info as possible from BNFbull (dosage administration etc)bull Appendix 6 Intravenous additivesbull Express question as an equation

Safety Check

bull Consider asking somebody else to check your work especially if tired stressed

• Prescribing IV Infusions
• Problem areas
• Prescribing infusions
• Volume
• Injectionsinfusions
• Compatibilities
• Practice 1
• Practice 1 -Answer
• Slide 9
• IV practice 2
• IV practice 2 -answer
• Slide 12
• IV practice 3
• IV practice 3 -answer
• IV practice 3 -answer
• Slide 16
• Self-check for IV prescriptions
• Calculations
• Safety Check

Safety Check

bull Consider asking somebody else to check your work especially if tired stressed

• Prescribing IV Infusions
• Problem areas
• Prescribing infusions
• Volume
• Injectionsinfusions
• Compatibilities
• Practice 1
• Practice 1 -Answer
• Slide 9
• IV practice 2
• IV practice 2 -answer
• Slide 12
• IV practice 3
• IV practice 3 -answer
• IV practice 3 -answer
• Slide 16
• Self-check for IV prescriptions
• Calculations
• Safety Check