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Lessons · Nursing · a bolus over a short time

A bolus: a set volume, fast

A bolus is a volume over a short stated time; the pump rate is volume × 60 ÷ minutes. A weight-based bolus is mL per kg times the kilograms, and then the same line.

Hone is a place to practise a career, one idea a day. This is one of its lessons, written out in full and free to read without an account.

What it is for

The order says 500 mL over 30 minutes and the pump is asking for mL/h. It is the piggyback arithmetic with a bigger bag, and a nurse who types the volume as the rate gives it over an hour instead of half of one.

How to think about it

If the order is per kilogram, find the volume first: mL/kg times kg. Then rate = volume × 60 ÷ minutes. Check that the rate is larger than the volume whenever the time is under an hour.

Worked example

Ordered 250 mL over 15 min
A quarter of an hour.
Rate = 250 × 60 / 15 = 1000 mL/h
Four quarter-hours in an hour, so four times the volume.
Ordered 20 mL/kg, patient 25 kg: 20 × 25 = 500 mL
A weight-based bolus. The volume first.
Over 20 min: 500 × 60 / 20 = 1500 mL/h
Then the rate, the same way.

Your turn

180 mL over 12 minutes. Write the pump rate line.

Rate = 180 × 60 /  = 900 mL/h

The trap

Typing the volume as the rate. 500 mL at 500 mL/h is an hour, and the order said fifteen minutes. The rate is what the pump would give in a whole hour, and a fifteen-minute bolus needs four times its volume.

Practise a bolus over a short time on HoneA question on it now, a coding challenge where there is one, and it is remembered for review. Free, no email needed.