To order a medicated IV, see Ordering Continuous IV Medications.
To order sequential IV fluids, write separate orders for each fluid, setting the start times and durations to indicate the sequence of infusion.
The default options and settings are determined by age group. To override the age group for a neonate, see Changing a Neonate Age For Orders.
Continuous IV fluids on inpatient and ED care units must be reviewed daily. See Rewriting IV Fluid Orders on Expiration.
If you haven't already:
Click Write (ALT+W).
Click IV Fluids (ALT+F).
Click Add (ALT+A).
Complete the form
Select an IV solution from the Fluids drop-down list.
In the ED only, for Fluids Not Stocked, click an option when prompted, then click OK (ALT+O).
For pediatric and neonatal patients only, for Less common fluids, click an option when prompted, then click OK (ALT+O).
If Other, type a description and click OK (ALT+O).
To include other substances, click Additives (ALT+A).
Select an additive from the drop-down list. If Other, type a description and click OK (ALT+O).
Type the volume in the Amount field. Units default to those appropriate for the patient's age group.
Click OK (ALT+O).
For more than one additive, select from the next numbered row. You can order up to eight additives.
The default is an IV drip. Click Bolus (ALT+B), Match (ALT+M), or Titrate (ALT+T) to change the IV type.
Match and Titrate are not applicable for hydration orders for chemotherapy.
Define the volume:
Drips: Type the amount for the rate of infusion. To order a weight-based rate, select ml/kg/hr for all patients, or ml/kg/day for neonates only, from the associated drop-down list.
Bolus: Type the amount. To order a weight-based rate, select ml/kg or ml/kg/hr for all patients, or ml/kg/day for neonates only, from the associated drop-down list. The order automatically includes "over" in the rate, to be followed by the duration (next).
Match: Select the fluid to match (urine is the default). For other, type a description when prompted.
Titrate (range rate): Type the amounts for both the minimum and maximum flow rate. To order a weight-based rate, select ml/kg/hr for all patients, or ml/kg/day for neonates only, from the associated drop-down list.
Indicate the duration:
Select an option from the list. Only time definitions are available for bolus IVs.
To order for a set length of time or volume, select an option from the Duration/amount drop-down list, then type the number of minutes, hours, liters, or mls for the IV to continue.
Select a Start Time (Now, Today, Stat, In AM, On Call to OR/CATH, At midnight tonight, or Other).
Select a site.
Type instructions as needed.
To order a saline lock:
Click the Yes option for Saline lock for POs > (greater than).
Set a goal for intake by mouth by typing a volume in the field (there is a 20-character limit on this field).
Chemo builders only: If needed, click the checkbox Print this IV Fluid Order grouped with Chemotherapy
IV Fluids with this option selected print when a session (pre-admit, NICO, or pending ambulatory) containing chemo orders is activated, then printed. In the case of split sessions, the IV Fluid is part of the non-chemo session, and is activated with these orders. However, when the chemo session is activated and printed, the IV Fluid prints in this group.
Click OK (ALT+O).
If you ordered a saline lock, you are prompted to select associated orders for the normal saline flush. Orders for D50W prompt for point-of-care blood glucose monitoring. When prompted, include associated orders as needed. See Consequent Orders for more information.
Write additional orders as needed,then sign the session.