IV "wide open" ??

Patient has a 21 gauge. MD writes order for 1L "wide open." Wouldn't that blow the vein?
When is it "safe" to run something wide open (in terms of gauge). This wasn't an emergent situation, patient just has frequent dizziness, so we had the order changes to 250 ml/hr rather than change the IV out to a bigger gauge. thoughts?
Quote from sassyann8585Patient has a 21 gauge. MD writes order for 1L "wide open." Wouldn't that blow the vein?When is it "safe" to run something wide open (in terms of gauge). This wasn't an emergent situation, patient just has frequent dizziness, so we had the order changes to 250 ml/hr rather than change the IV out to a bigger gauge. thoughts?

We do it all the time when the situation warrants.

Quote from sassyann8585Patient has a 21 gauge. MD writes order for 1L "wide open." Wouldn't that blow the vein?When is it "safe" to run something wide open (in terms of gauge). This wasn't an emergent situation, patient just has frequent dizziness, so we had the order changes to 250 ml/hr rather than change the IV out to a bigger gauge. thoughts?

Quote from ChristineNNo it won't blow the vein. We give fluids "wide open" in the ER all the time.

I know there are maximum flow rate recommendations and I found one site. I'm sure it's possible to blow the higher gauge sites if the fluids really were to run wide open. What I've seen emergency personnel do a lot of times though is take the bag off the pole and flat out squeeze it, and I'm sure this technique makes most peripheral veins prone to infiltration/blowing.http://update.anaesthesiologists.org...Pdate_2011.pdf

If it is run open on gravity the body will manage the rate. I have run IVF at 999 ml/hr as well and not infiltrated. If the IV does infiltrate, as it did on me personally, it is more likely from the initial placement.

Quote from NurseOnAMotorcycleIn emergency room just about everyone gets a 1000 ml wide open bonus unless they are dialysis, chf, etc. Our smallest gauge we'll open up on is a 20. MDs generally don't know the IV size vs rates. They depend on us to tell them the IV is too small to handle it.

have squeezed in on pressure bags or by hand fluids, blood products without incident on 20's and rarely 22's. Usually you can only force so much through the small gauge so it will limit you there. Our OR's are starting to do surgeries with only 22's now, as they have been finding more and more how the larger gauge is harmful to the veins.

I've never seen a 21g IV, is this a butterfly that's being taped down? And as others have said, no its not gonna blow the vein, the catheter size and vasculature itself will self-control how fast the fluid actually flows its not like forcing water into a balloon until it bursts.

If the pressure of a IV bag will blow the vein then the pressure of the 10cc flush you used when you first started the IV would definitely have blown the vein, since the force and pressure from that far exceed what a IV bag would give. If it is a patent line then you will be just fine running it wide open.

Quote from TiffyRNWhat I've seen emergency personnel do a lot of times though is take the bag off the pole and flat out squeeze it, and I'm sure this technique makes most peripheral veins prone to infiltration/blowing.

The lumen of the IV tubing is going to be quite a bit larger than the lumen of your 18gauge or 20gauge for 22gauge (or whatever gauge) IV catheter you are going to use. Effectively, the lumen of the the catheter that you are going to be using is going to be the major restriction on the flow rate of the IV. If you look at the packaging on the catheter, there should be a note as to what the maximum flow rate is for gravity and pressure infusion. If you are doing a gravity bolus, the body will also regulate the maximum flow rate that can be achieved.To my knowledge, I have never blown an IV while doing a gravity bolus, if the catheter was properly placed. I have seen instances where there was some infiltration that became readily apparent during a gravity bolus, but that is simply because the catheter was not properly placed into the vein.Quite frankly, I would be more concerned about blowing an IV that is being supplied fluids via pressure infuser than by gravity.That is my experience as a paramedic, I'm sure that the experiences of many of the RNs here are very similar.