Is there a maximum rate/hour for peripheral IV's. Example: Total of 412 ml/hr through one 22 ga. catheter in the hand. Has anyone seen problems with mixing Aminophylline, LR and Azithromycin in one line, even though Micromedex indicates they are all compatible? Prior to this combo, Levafloxacin and Solu-Medrol went through the same line.
Constance J. Paine, RN, CCRN
The rate of infusion or the total volume being infused is not the issue. A 22 g short peripheral catheter can accommodate more than 2000 mLs an hour. I am not sure what generated your questions and that would help to better address the issues. All nurses must practice according to the Infusion Nursing Standards of Practice - available for purchase at www.ins1.org.- plus other documents from CDC, ONS, ASPEN, etc.
Final osmolarity and pH of the solution dictates what should and should not be infused through a peripheral vein. pH below 5 and above 9 and osmoslarity greater than 600 mOsm/L will greatly increase the risk of phlebitis/thrombophlebitis. But there are numerous other factors that must be considered. Sites in an area of joint flexion, lack of appropriate stabilization (tape and a dressing is not adequate increase the risk of infiltration/extraasation. incorrect infusion methods also influence risk of phlebitis/thrombophlebitis. Nerve damage is associated with venipuncture technique and infiltration. Inappropriate skin antisepsis increase risk of infection. In the INS standards, see the standards of Site Selection, Catheter Selection, Catheter Stabilization, Catheter Dressing, Parenterial Fluid and Medication Administration, plus all the rest.
I notice that you are a legal consultant, so I am not sure if you are reviewing a set of medical records for a possible lawsuit or if you are seeking to improve patient care, or write hospital policy/procedure. So I am not really sure what other information I can provide. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861