Accuracy of Intravenous Infusion Flow Regulators in the Prehospital Environment

Loner, Carly; Acquisto, Nicole M.; Lenhardt, Heather; Sensenbach, Benjamin; Purick, Julie; Jones, Courtney Marie Cora; Cushman, Jeremy T.

doi:10.1080/10903127.2018.1436208

Cited by 11 publications

(10 citation statements)

References 2 publications

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“… 5 6 7 In addition to viscosity, pressure of the fluid can affect the flow rate. The flow rates were consistently slower than expected at lower heights and faster than expected at higher heights, 8 and therefore fluid containers must be hung at the height recommended by the IIFR’s manufacturer’s instructions.…”

mentioning

confidence: 78%

The Effects of Intravenous Fluid Viscosity on the Accuracy of Intravenous Infusion Flow Regulators

Song

Choe

et al. 2022

J Korean Med Sci

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Intravenous infusion flow regulators (IIFRs) are widely used devices but it is unknown how much the difference between the IIFR scale and the actual flow rate depends on the viscosity of the intravenous (IV) fluid. This study evaluated the effects of viscosity on the flow rate of five IV fluids (0.9% normal saline, Hartmann’s solution, plasma solution-A, 6% hetastarch, and 5% albumin) when using IIFRs. The viscosity of crystalloids was 1.07–1.12 mPa·s, and the viscosities of 6% hetastarch and 5% albumin were 2.59 times and 1.74 times that of normal saline, respectively. When the IIFR scales were preset to 20, 100, and 250 mL/hr, crystalloids were delivered at the preset flow rate within a difference of less than 10%, while 6% hetastarch was delivered at approximately 40% of the preset flow rates and 5% albumin was approximately 80% transmitted. When delivering colloids, IIFRs should be used with caution.

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mentioning

confidence: 78%

The Effects of Intravenous Fluid Viscosity on the Accuracy of Intravenous Infusion Flow Regulators

Song

Choe

et al. 2022

J Korean Med Sci

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“…Even when using intravenous infusion flow regulators, significant deviations from volume and flow rates are possible, leading to potential medical delivery errors. 2 When delivering fluid volumes alone, accuracy may be highly variable. 4 In this randomized, cross over study, use of a metronome was associated with greater ease of use and shorter time to goal infusion rate.…”

Section: Discussionmentioning

confidence: 99%

“…Even when using intravenous infusion flow regulators, deviations from expected infusion volumes are common and potentially harmful. 2,3 Conventional calculation of prehospital IV infusion rates requires a mathematical computation based on the medication dose, delivery interval, and number of drops in the IV administration set per volume. Thus, a method to mitigate the difficulty and potential for error when administering prehospital IV infusions could assist EMS clinicians by facilitating accurate infusion control.…”

Section: Introductionmentioning

confidence: 99%

Comparison of a Metronome-guided Prehospital Medication Infusion Technique with Manual Calculation: A Simulated Randomized, Controlled, Cross-over Study

Galvagno

Cloepin

Hannas

et al. 2021

Preprint

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BackgroundLimited research regarding administration of timed medication infusions in the prehospital environment has identified wide variability with accuracy, timing, and overall feasibility. This study was a pragmatic, randomized, controlled, crossover study comparing two different techniques for medication infusion administration. We hypothesized that the use of a metronome-based technique would decrease medication dosage errors and reduce time to administration for intravenous medication infusions. Methods Forty-two nationally registered paramedics were randomized to either a metronome-based technique versus a standard stopwatch-based technique. Each subject served as a control. Subjects were asked to establish an infusion of amiodarone at a dose of 150 mg administered over 10 minutes, simulating treatment of a hemodynamically stable patient with sustained monomorphic ventricular tachycardia. Descriptive statistics and multiple linear regression were used for data analysis. Results When compared to a standard stopwatch-based technique, a metronome-based technique was associated with faster time to goal, fewer mid-infusion adjustments, and greater ease of use. Conclusions Use of a metronome technique for establishing medication infusion rates may help prehospital clinicians provide safer and more precise medication delivery.

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“…Administration of intravenous medication infusions in the prehospital arena is an arduous task. Even when using intravenous infusion flow regulators, significant deviations from volume and flow rates are possible, leading to potential medical delivery errors [ 2 ]. When delivering fluid volumes alone, accuracy may be highly variable [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…An infusion pump is preferred to ensure appropriate dosing, but such devices are expensive, require extensive training, and are not available in many EMS systems. Even when using intravenous infusion flow regulators, deviations from expected infusion volumes are common and potentially harmful [ 2 , 3 ]. Conventional calculation of prehospital IV infusion rates requires a mathematical computation based on the medication dose, delivery interval, and size of the IV administration set.…”

Section: Introductionmentioning

confidence: 99%

Comparison of a metronome-guided prehospital medication infusion technique with standard calculation: a simulated randomized, controlled, cross-over study

et al. 2021

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Background Limited research regarding administration of timed medication infusions in the prehospital environment has identified wide variability with accuracy, timing, and overall feasibility. This study was a quality improvement project that utilized a randomized, controlled, crossover study design to compare two different educational techniques for medication infusion administration. We hypothesized that the use of a metronome-based technique would decrease medication dosage errors and reduce time to administration for intravenous medication infusions. Methods Forty-two nationally registered paramedics were randomized to either a metronome-based technique versus a standard stopwatch-based technique. Each subject served as a control. Subjects were asked to establish an infusion of amiodarone at a dose of 150 mg administered over 10 min, simulating treatment of a hemodynamically stable patient with sustained monomorphic ventricular tachycardia. Descriptive statistics and a repeated measures mixed linear regression model were used for data analysis. Results When compared to a standard stopwatch-based technique, a metronome-based technique was associated with faster time to goal (median 34 s [IQR, 22–54] vs 50 s; [IQR 38–61 s], P = 0.006) and fewer mid-infusion adjustments. Ease of use was reported to be significantly higher for the metronome group (median ranking 5, IQR 4–5) compared to the standard group (median ranking 2, IQR 2–3; P < 0.001). Conclusions Knowledge regarding a metronome technique may help EMS clinicians provide safe and effective IV infusions. Such a technique may be beneficial for learners and educators alike.

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Accuracy of Intravenous Infusion Flow Regulators in the Prehospital Environment

Cited by 11 publications

References 2 publications

The Effects of Intravenous Fluid Viscosity on the Accuracy of Intravenous Infusion Flow Regulators

The Effects of Intravenous Fluid Viscosity on the Accuracy of Intravenous Infusion Flow Regulators

Comparison of a Metronome-guided Prehospital Medication Infusion Technique with Manual Calculation: A Simulated Randomized, Controlled, Cross-over Study

Comparison of a metronome-guided prehospital medication infusion technique with standard calculation: a simulated randomized, controlled, cross-over study

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