You do not have many fluid pumps, so you want to add the medication to the patient’s maintenance fluids.
MED MATH PRACTICE WITH EXAMPLE ORDERS TRIAL
You have ruled out mechanical obstruction, so you want to trial a metoclopramide CRI to see if it will make any difference to their comfort and appetite. Example 1: You have a 10 kg canine patient in with a suspected ileus. Metoclopramide is typically given at 1-2 mg/kg/ day.Ī. If you are making a separate bag for the CRI or using a syringe driver, then it is easiest to use even flow rates to make titrations easier (usually 2-10 mL/hour).ģ) Decide your dose and create your mixture.
For example, if you are adding metoclopramide to a patient’s current intravenous fluids then you will use their fluid rate as a starting point. Websites such as good information on drug interactions, but if you have any questions then check the Data Sheet, your formulary, or contact the manufacturer.Ģ) Decide at what rate you wish to administer the CRI.
If using multiple drugs, ensure there are no interactions between them. Detailed explanation of the use, effects, and interactions of specific drugs are beyond the scope of this article, but may be found in formularies such as the BSAVA Formulary or Plumb’s Veterinary Drugs Handbook, as well as various other texts.ġ) Painful elective procedures such as orthopaedic or thoracic surgery.Ģ) Moderate to severe post-operative pain.ģ) Trauma such as bite wounds, road traffic accidents, or fractures.Ĥ) Patients with co-morbidities such as cardiac or respiratory compromise who would benefit from the anaesthetic gas sparing effects of CRIs.ĥ) Patients with hepatic or renal disease that may not be good candidates for anti-inflammatories orĦ) Treating seizures or arrhythmias refractory to boluses of medication.ħ) Treating electrolyte or glucose imbalances.Ĩ) Metabolic conditions such as diabetic ketoacidosis.ġ) Decide what medication(s) you wish to administer and ensure they are appropriate for your patient. This article will aim to give examples of patients that may benefit from a CRI and discuss the mathematics and logistics behind administering them. Several different medications can be administered as constant rate infusions, including anaesthetic, analgesic, sedative, antiarrhythmic, and anticonvulsant agents.
MED MATH PRACTICE WITH EXAMPLE ORDERS DRIVERS
They are administered using standard fluid pumps or with syringe drivers (either electronic or spring loaded), and many medications can be added to a patient's pre-existing intravenous fluids. Originally published on Veterinary ECC Small Talk: Ĭonstant rate infusions (CRIs) are a simple, flexible, and inexpensive way to administer intravenous medications to hospitalised and surgical patients.
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