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Module 5 : OSCE Video and Mark Sheet

 

 

Introduction

 

During clinical attachments you may have the opportunity to set up an IV fluid infusion for a patient, and certainly by 5th year it is a required practical skill.

 

The video section of this module is a guide to how to set up an IV fluid infusion. It is aimed to teach students earlier on in their clinical training, as well as to consolidate the procedure for those in their later years of study. This video should also cover the main points required of an OSCE station.

 

A print out of an OSCE checklist for setting up an IV fluid infusion is available for student notes and OSCE practice.

 

 

How to calculate the giving set drip rate


Follows is how to calculate the drip rate required to deliver the prescribed rate of fluid:

 

Each giving set states on the back its 'GTT' value (from the latin guttae; drops)- the number of drops in one mL.


GTT value allows you to calculate how many drops/min of fluid dropping through the giving set
chamber you need to set in order to give the correct amount of fluid in the required time. Here is an easy formula you can use to calculate this:

Formula

*note that a standard fluid giving set often has a gtt of 20, although a blood giving set is usually 15. However this may vary, check the packaging of the giving set to be sure.

 

 

A worked example

 

1L normal saline given over 8hr using a standard giving set would require a drip rate of:

 

: 1000ml x 20 / 8 x 60 = 42 drops/min (or 7 drops over 10sec)

 

Note that although giving sets are still often used stand alone to deliver a prescribed rate of fluid, electronic infusion devices can also be used when greater accuracy is required.

 

Cannulae

 

All cannulas say on the back of the packaging the maximum flow rate ml/min.


Even small cannulas can often support the required infusion rate.

 

e.g. for the example above:
1000ml/ 8 x 60 = 2ml/min required to infuse via the cannula to deliver the fluid over 8 hours.


The small Pink 20G cannula can do 50ml/min thus rarely is the cannula the rate limiting step in routine use. However, in emergencies where very large volumes may need to be given over a short period it is vital to use a wide bore cannulae (grey/brown/orange). For more information see Prescribing : Intravascular repletion.

 

 

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