Infusion Drop Formula – To find out the formula for infusion drops, you must first know the volume of fluid, the duration of administration, and the drop factor. You can learn it yourself too. Knowing how to calculate the required infusion drops according to the patient’s needs is as important as understanding the type and dosage of medicine that must be given to the patient so that he recovers quickly.
This task is usually performed by medical personnel who monitor your condition. However, as a patient, there is nothing wrong with learning this basic technique with simple calculations.
Definition of Infusion
Intravenous infusion or therapy is the infusion of a liquid or drug into the body via the intravenous route at a constant rate over a period of time. Infusion is done for a patient who needs medicine very quickly or who needs to give medicine slowly, but continuously.
Administering drugs or fluids into the body through the mouth will enter the digestive process first, so they are not quickly absorbed by the body. During the digestion process, it is also possible that there are digestive enzymes that will change or break down the medicine you are taking, so it will be less effective and better if it enters the bloodstream directly through an IV.
Infusion is done by inserting a small needle into a vein. Usually, the needle is implanted near the patient’s elbow, wrist, or on the back of the hand. Apart from the hands, the infusion can also be placed on the legs. The speed at which the patient absorbs infusion fluids depends on the patient’s body condition and the disease he is suffering from. The number of infusion drops every minute will be monitored by a nurse using the infusion drip formula which will be explained in the next section.
The purpose of infusion is differentiated based on the fluid given. The two types of fluids include:
1. Crystalloid Liquid
This type of liquid contains sodium chloride, sodium gluconate, sodium acetate, potassium chloride, magnesium chloride and glucose. Generally given to maintain electrolyte balance, hydrate the body, restore pH and as fluid resuscitation.
Three types are included in crystalloid fluids, namely:
- Saline liquid, which contains sodium and chloride as much as 0.9%.
- Ringer’s lactate, which contains potassium, calcium, lactate, sodium, water, and chloride.
- Dextrose, which contains simple sugars to increase blood sugar levels in hypoglycemia patients (low blood sugar).
2. Colloidal liquid
This liquid has a heavier molecular content than crystalloids. Colloid fluids are given to critically ill patients, major surgeries, and for fluid resuscitation.
Three types are included in colloidal fluids, namely:
- Gelatin, which contains animal protein to prevent reduced blood volume in the body.
- Albumin, which contains albumin to replace lost levels due to surgery, serious injury, or sepsis.
- Dextran, which contains glucose polymers to improve the recovery process for patients who have lost a lot of blood.
Benefits of Infusion
This method is given to patients who experience a lack of electrolytes and body fluids due to dehydration. Infusions are also given to patients who cannot eat and drink and whose nutritional intake is not met.
When to Do an Infusion?
Not all diseases require infusion. This method is only needed for patients with emergency conditions that require the drug to enter the body quickly. Some of these conditions include heart attack, poisoning, or stroke.
Some of the conditions mentioned earlier make it impossible to take medication by mouth because it takes longer for it to be absorbed into the bloodstream. This can cause exacerbation of the disease experienced. Infusions are also needed when the patient experiences vomiting and diarrhea and loses a lot of body fluids. With an infusion, the process of changing electrolytes and fluids becomes faster.
Conditions that require infusion include:
- Severe dehydration.
- Food poisoning.
- Heart attack.
- Immune system disorders.
- Administration of chemotherapy drugs.
- Chronic inflammation.
First of all, the medical team will determine the type of infusion to be given to the patient. Furthermore, the infusion is injected through the skin that has been cleaned beforehand into a vein. Infusion must be carried out by an experienced medical team. This method can be done at a health care provider or clinic. If you wish to do so, please make a hospital appointment for the procedure.
Preparation How to Count Infusion Drops
To learn how to count these infusion drops, you have to prepare basic equipment such as needles and syringes to remove medicine or liquid from the bottle. In addition, a flush is also needed to push the drug into the intravenous tubing or fluid bag.
There are two methods of administering intravenous fluids, also known as the drip factor, namely the macro set and the micro set.
1. Macro Set
To give 1 mL of infusion fluid, during the infusion process, the nurse will open the infusion drip hole with a larger diameter, so that the number of drops that comes out is also smaller, namely only 10-20 drops.
2. Micro Sets
To give 1 ml of infusion, the infusion drip hole is only slightly opened, so that the number of drops that comes out is also more, namely 45-60 drops.
Determination of macro or micro sets will depend on preferences and needs according to doctor’s instructions. However, the standard that is usually used depends on the type of fluid that must be put into your body. If the fluid is clear and watery, the nurse may infuse it at 20 drops/1 mL. Meanwhile, if the IV fluids are thicker like blood, you will probably get 15 drops/1 mL.
Infusion Drop Factor
1. Macro Drip Factor
There are only two macro drips used in Indonesia. It depends on the brand of the infusion set and the drip factor. For the Otsuka brand infusion set , the drop factor used was 15 drops/ml, while for the Terumo brand infusion set, the drop factor used was 20 drops/ml.
For a drop factor of 10 drops/ml, it is rarely used in Indonesia. However, they can usually be found in central public hospitals, national referral hospitals, and teaching hospitals. The macro drop factor is usually used to calculate the amount of fluid requirements for adults. For blood transfusions, a drop factor of 15 drops/ml is usually used.
2. Micro Drip Factor
In contrast to adults, children weighing less than 7 kg require different infusion sets and drip factors. Usually, for children, a drop factor called micro drip is used , which is 60 drops/ml.
Infusion Drop Formula
In administering infusion drops with an automatic machine, the nurse only has to input the amount of fluid that must enter your body and the time needed to put it into the body. Meanwhile, if intravenous fluids are added manually, how to count infusion drops is done by knowing the number of drops per minute (TPM).
The TPM calculation formula itself is:
(drop factor x fluid volume) / (60 x administration time in hours)
The drip factor is an important element in how to calculate infusion drops that medical personnel need to know. As explained above, the nurse can choose either a macro or a micro set. For example, a doctor instructs a patient to receive 500 mL of infusion fluids within 8 hours, while the set drop factor is 20. With this data, how to calculate the infusion drops that must be given to the patient, namely:
(500 x 20) / (60 x 8) = 20.83.
That is, you will get about 20–21 drops of IV fluids in 1 minute before the fluid in the IV bag runs out and is replaced with new fluid.
Know the Types of Infusion Liquids
After knowing how to calculate and the formula for infusion drops, it is also important for you to recognize the type of infusion fluid itself. Based on its use, the types of infusion fluids themselves are divided into four groups, namely maintenance fluids, replacement fluids, special fluids, and nutritional fluids.
1. Maintenance Fluid
This intravenous fluid is usually given to patients who cannot meet electrolyte needs, but are not yet at a critical or chronic stage. The goal of giving these fluids is to provide enough fluid and electrolytes to cover insensible losses (500–1000 mL), maintain normal body status, and allow renal excretion of waste products (500–1500 mL).
The types of infusion fluids that can be used are 0.9% NaCl, 5% glucose, glucose saline, and Ringer’s lactate or acetate. Giving intravenous fluids must still be recommended by a doctor or competent health worker.
2. Substitute Fluid
These intravenous fluids are given to patients with electrolyte deficiencies and internal fluid redistribution problems. These fluids are usually needed in patients who have problems with the gastrointestinal tract (ileostomy, fistula, nasogastric drainage, and surgical drainage) or urinary tract (eg, during recovery from acute renal failure).
3. Special Liquid
The special liquid in question is a crystalloid such as 7.5% sodium bicarbonate or calcium gluconate. The purpose of giving intravenous fluids is to relieve electrolyte balance disturbances that occur in the body.
4. Nutrition Liquid
When the patient doesn’t want to eat, can’t eat, or can’t eat by mouth, this nutrient-filled IV will be put into the body. This nutritional liquid is given if the patient experiences:
- Impaired absorption of food, such as enterocunateus fistula, intestinal atresia, infectious colitis, or small bowel obstruction.
- Conditions requiring bowel rest, such as severe pancreatitis, preoperative state with severe malnutrition, intestinal angina, mesenteric artery stenosis, and recurrent diarrhea.
- Bowel motility disorders, such as prolonged ileus, pseudo-obstruction, and scleroderma.
- Eating disorders, persistent vomiting, hemodynamic disturbances, and hyperemesis gravidarum.
Regardless of the type of liquid, the way to calculate infusion drops remains the same, namely using the infusion drops per minute (TPM) formula.
Sample Problem Counting Macro Infusion Drops
Patient A intends to be given 250 cc of 0.9% NaCl in 2 hours. It is known that the drip infusion factor is 15 drops/minute. The number of drops per minute (TPM) is…
TPM = (fluid requirement x macro drop factor)/(time of administration x 60 minutes)
TPM = (250 x 15)/(2×60)
TPM = 3750/120
TPM = 31.25
TPM = 32 drops/minute (rounded)
Patient B intends to be given 250 cc of 0.9% NaCl in 10 hours. It is known that the drip infusion factor is 60 drops/minute. The number of drops per minute (TPM) is…
TPM = (fluid requirement x macro drop factor)/(time of administration x 60 minutes)
TPM = (250 x 60)/(10×60)
TPM = 15000/600
TPM = 25
TPM = 25 drops/minute
The available 500 cc of liquid must be used up in 10 hours. How many drops per minute?
TPM = (fluid requirement x macro drop factor)/drip determined (hours) x 60 minutes
TPM = (500 x 20)/(10 x 60)
TPM = 16.6
TPM = 17 drops/minute (rounded)
The available 500 cc of liquid must be used up in 12 hours. How many drops per minute?
TPM = (fluid requirement x micro-drop factor)/(set time (hours) x 60 minutes
TPM = (500 x 60)/(12 x 60)
TPM = 41.6 drops/minute
TPM = 60 seconds/41.6 TPM drops
= 1.4 (1 drop every 1.4 seconds)
The available liquid is 500 cc of 0.9% NaCl. Administered by infusion titration of 40 drops/minute. How many hours will it take for the liquid to run out?
TPM = (fluid requirement x microdrop factor)/(droplets determined (hours) x 60 minutes
TPM = (500 x 60)/(40 x 60)
TPM = 12.5 hours
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