## Calculating I.V. drip rates with confidence

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While you’re working your shift on the progressive care unit, the physician phones in an order to start a patient’s I.V. dopamine infusion at 5 mcg/kg/minute. As you hang up the phone, your mind starts to race: How fast should I set the infusion pump to deliver 5 mcg/kg/minute? Will I be able to remember the complex drip rate equation I learned in nursing school? Will I have to mix the solution or will it come premixed? Will I have to titrate the drug myself, or will I get a regular physician’s order? If I need to titrate it myself, can I do this on my unit?

Many nurses are expected to deliver and titrate I.V. drugs regularly. Such factors as unit protocols, titration policies, and the specific drug ordered determine exactly how you’ll deliver and titrate an I.V. drug.

Today, with an emphasis on patient safety, the pharmacy staff customarily mixes the majority of drug solutions and also may calculate infusion pump rates. Many pharmaceutical companies have gotten in on the act, too, providing a drip rate matrix.

Although many I.V. infusion pumps calculate drip rates automatically, these rates must be double-checked to ensure patient safety. So chances are you’ll need to calculate I.V. drip rates and titration scales yourself.

If you feel uneasy when performing these critical tasks, you’re not alone. To boost your confidence, this article presents simplified equations to help you breeze through selected I.V. drip rate calculations.

NOTE TO READER: For the sake of accuracy, the rest of this article is available in PDF format only. Click the PDF icon above to access the PDF. Thank you.

#### 7 Comments.Leave new

• Karla Huntsman, RN, MSN
August 15, 2011 9:17 am

I am dismayed to find this in your “most popular articles” archive. While this system may work for some nurses, I believe that it should not be adopted overall. The fact that conversions must be made prior to using the formula, and the use of the unlabeled constant “60” (even if you know why it is there) makes this a setup for error. I believe that nurses, especially in critical care, MUST be able to use dimensional analysis for maximum safety. This is no place for shortcuts!

• as a 30 yr. nurse i find it important to know how to do the calculations especially for some tests. but i endorse fully the use of computer and pharmacy doseon the bags.

• spiritualnurse
November 18, 2010 1:03 am

The hospital where I work the pharmacy mixes all drugs and calculates all dosages.We cannot give any medication whether doctors phone or not without the pharmacy involved.It is easier for us though.We also have the tube system so we get the drug immediately from the pharmacy.

• June E. Porter MSN RN CS
May 6, 2010 7:28 am

Although other methods of drug calculations have been taught in the nursing classroom for many years, I concur with my colleagues here that D.A. proved to be the most accuarate in my years of clinical practice. Little did I know that skills taught in chemistry class reduced med error considerably.

• I would agree with my colleague that Dimensional Analysis is the BEST mthod for medication dosage calculation. You cannot made an error. You will have your answer ONLY if very part of the DA equation is set up correctly. This article has too many potential steps for an error to occur. I must admit I am a convert to DA and have been sharing the merits of this method to other nurse educators as often as possible.

• S. Greenfield
April 9, 2010 9:32 pm

Unfortunately, I find this method fraught with the possibility of error. Anytime you delete the “units” or need multiple calculations it is a set up for mistakes. Building on the dimensional analysis learned in freshman chemistry, med calculations can be done without the use of any formulas and is safer. See Craig’s book, Clinical Calculations Made Easy by LWW or the article by Greenfield, “Use of Dimensional Analysis to Reduce Medication Errors” in the Journal of Nurse Educator, Feb 2006

• Thank you for these tips and formulas. As a new RN this info. decreases my anxieties of drip calculations.