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 Indeed, the use of infusion pumps for all fluids and medications in US hospitals is quite common today but this was not always the case. I think we have gone overboard with use of and total reliance on these devices. It became accepted practice in the 1990's during numerous work redesign initiatives when we began to use pumps on everything. This was during the movement of expecting more productivity from individual nurses due to cutting costs and staffs. Nursing time was not well spent to manually regulate fluids with a roller clamp and counting drops. It was ALWAYS considered best practice to use infusion pumps for critical fluids such as all parenteral nutrition, cardiac/pressor meds, othr critical meds such as heparin, aminophylline, insulin, pain meds, high concentrations of KCl, etc. Roller clamp accuracy is rated to be +/- 25%, manual flow regulators are the same accuracy ratings, infusion pumps +/- 5 to 10%. So infusion pumps were also seen as a risk management strategy to avoid severe under or over infusion. I have written numerous hospital policies on the criteria for when a pump is required with all other patients infused by gravity. See the INS Infusion Nursing Standards of Practice on Flow Control Devices for the established criteria to use for choosing the method of flow control. I am definitely not surprised that other countries are not using pumps. The costs of the pump along with the expectations of nursing practice being quite different in each country are the reasons for this. Lynn