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Redhead RN
Volume Controlled Devices, i.e. Volutrol or Buretrol

Does anyone have any research or best practice data on which IV tubing is better to infuse medications in an ICU setting.  Specifically advantages/disadvantages of using a Buretrol versus secondary tubing to deliver intermittent medication?  Currently our ICU uses a Buretrol administration set & there is some resistance to changing to a secondary administration set.  I understand there can be issues with development of precipitate from inadequate flushing of the buretrol.  Is there any other advantages/disadvantages?  Thank you

 I can not point to published

 I can not point to published studies on these devices, however the ISMP has raised serious concerns about this practice. Also I think the use of these volume controlled devices is decreasing. One of the greatest problems is the fact that the label on the device is difficult to control. How do you label it when the medication is present and infusing vs when only fluids are infusing? How do you ensure appropriate standardize amount of dilution for each medication? Most antibiotics are provided as lyophylized powders which must be reconstituted, then added to the device with additional dilution. This is compounding practice that is now required to be done in a laminar airflow workbench. Ask your pharmacy about compliance with USP 797. Any medication prepared outside of these workbenchs MUST be infused within 1 hour of the time you begin the compounding process. This immediate use category should only be used when the patient will be at greater risk by waiting on the drug properly compounded in these workbenches. INS, ISMP, and USP establish the national standards on this practice, so you will need all of that information to guide your change in practice. Lynn

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

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