IV Flow Rate and Infusion Math Made Simple!Jul 4th, 2022
IV Flow Rate and Infusion Math
IV flow rate and infusion math can feature on the PTCB exam. Whilst it may not feature heavily, candidates should still prepare for these kinds of question for the pharmacy technician exam. After all, one question can be the difference between passing and failing.
As with all types of math question, the strategy is about breaking things down to the simplest possible level. Then, you can work your way up toward a complete understanding of the subject.
Sure, this takes time.
But it’s worth it, because once mastered, IV flow rate and infusion math can become some of the easiest questions to answer on the PTCB test. It may not seem like it now but, in time, it can.
Here, we will provide a broad overview of the subject as well as reviewing some sample questions – breaking each question down on a step-by-step level to help you come to terms with this kind of PTCB math question.
What are infusions and why are they needed?
Infusion therapy is widely delivered to patients for many different reasons.
Infusion therapy means that medicine is delivered to the patient via a needle or catheter – typically via the intravenous rote, direct into veins. This mode of drug administration is particularly helpful when patients cannot take medicines via the oral route. Instead, the medicine can be delivered direct into the bloodstream where it can have a more rapid effect.
Remember: it takes time for orally administered drugs to work. They need to bypass the enzymes of the oral cavity; the acidity of the stomach; the enzymes that flow into the upper intestinal tract; and the hefty metabolism of the industrial liver. IV infusions bypass this traffic – instead, going direct to the bloodstream where they can exert a more rapid effect.
For similar reasons, infusions are also effective for drugs that cannot withstand the metabolism, acidity, and enzymes of the GI tract. These drugs would get broken down and not make it to the bloodstream. Instead, they must be administered direct into the veins.
IV pumps are also helpful for patients who need to sustain hydration or in patients who must have their electrolyte levels boosted.
Infusion therapy allows drug to be administered quickly or slowly – depending on the needs of the patient and their condition. For example:
- a patient having a heart attack or an anaphylactic reaction or a stroke, can be treated quickly with an IV infusion. Time is of the essence in these emergency situations and IV infusions are highly effective.
- similarly, some IV infusions are administered slowly – with a controlled drop rate – as we often see in chemotherapy, for instance.
These are some of the core reasons why IV flow rate and infusion math is tested on the PTCB exam.
Infusions and flow rates play a critical role in the day-to-day therapeutic management for many patients. Pharmacy technicians are expected to understand not only the mechanisms of working this math out, but to do so in an accurate and responsible manner.
This is the foundational duty of every healthcare professional.
IV Infusion and Flow Rate Math Questions
Remember: on the PTCB exam there are 90 questions, only 80 of which are scored.
Therefore, the number of PTCB math questions asked is limited – and IV flow rates and infusions may only form a small part of your exam. In fact, it may not feature at all!
But nobody knows what will appear and what won’t appear, and so preparation is essential.
Moreover, pharmacy technicians should actively learn this topic regardless, not least because of its core relevance to their career.
Below, we review two sample PTCB IV flow rate and infusion questions. We break each question down – and detail the important elements you should keep in mind when answering these questions. Try to attempt each question first, and note the method you are using, before reading the explained answers. Then, compare your method versus our detailed explanation. Even if you manage to find the correct answer, you may find new ways to understand how to go about solving the problem in a more safe and effective manner; reducing the risk of tripping over the correct answer of future questions.
A patient receives an infusion of 220 mL/hr of drug from an IV bag that contains 3L. Approximately how many hours will the infusion last?
Each hour that the patient is receiving the infusion, 220mL of medicine is being administered.
In total, the patient will receive 3,000mL (remember, always convert units!).
Therefore, 3000mL / 220mL per hour = 13.6 hours
Units are critical. Whilst this is a more basic example of an infusion question, the principle is core to many more difficult problems (and even many other topics in pharmacy technician math).
By double-checking units are consistent, and by having the knowledge in advance to identify and perform these conversions, it makes the math operations much easier and far more practical. It helps to avoid unnecessary and avoidable mistakes.
A 58-year-old patient has been admitted to hospital with a suspected poisoning. An infusion of 1,600mL is administered to a patient over a 6-hour period.
If the calibration rate is set to 8 gtts/mL, how many drops per minute will the patient receive?
First question: are units consistent?
We are talking about a “6-hour period”, whilst the question is asking us to calculate “drops per minute”. Therefore, the first job is to convert 6-hours to minutes.
6 hours x 60 = 360 minutes
Now over that 360-minute period, the patient receives 1,600 mL. We need to find out how much mL the patient received for each minute of that 360-minute period.
And we do that by simple division:
1,600 mL / 360 minutes = 4.44 mL per minute
So, for the 6-hours that the patient is receiving the infusion, they are receiving 4.44 mL each minute.
The reason we need to perform the above operations is because the question is asking us to calculate “how many drops per minute” the patient will receive.
We are told the calibration rate: it’s 8 drops per mL (gtts is the pharmacy abbreviation for “drops“!).
In other words, for each 1 mL the patient receives, 8 drops is infused into their body (8 drops = 1 mL).
But we have worked out that 4.44 mL is being administered. Therefore, we simply need to perform the following multiplication step:
4.44 mL per minute x 8 drops per mL = 35.5 drops per minute.
- The patient receives an infusion of 1,600 mL over a 6-hour period.
- We established that this is the equivalent of 4.44 mL for each minute.
- We are told that there are 8 drops in 1 mL (the set calibration rate for the infusion).
- Therefore, 4.44mL contains 35.5 drops – administered per minute over the entire 6-hr infusion.
Once you break down what’s happening with IV flow rate and infusion math, the PTCB exam questions become much more manageable.
Take Home Message
IV flow rate and infusion math has a bad reputation.
But as we’ve shown here, it doesn’t need to be difficult. It’s about breaking the question down to its most fundamental parts and understanding what is going on.
One of the biggest mistakes that pharmacy technicians make is relying on memorizing formulae. This is great, of course, if the formulae are understood and applied correctly. Often, however, formulae are memorized without a clear understanding of how to properly apply these formulae to different PTCB math questions. This can lead to simple and avoidable mistakes.
The two examples we reviewed attempted to break down the questions without relying on formulae. Instead, the focus was on stripping back the question and understanding exactly what’s going on at the most basic, step-by-step level. This is what creates understanding.
By starting here, and building up, your knowledge base of IV flow rate and infusion math will grow faster and – more importantly – with a greater sense of understanding of what the question is asking and how to develop a plan to work out the correct answer: accurately, reliably, and informed.
Then, your confidence with this kind of math will grow and – no matter what the PTCB exam throws at you – you’ll have the topic well and truly covered!
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