Common calculations for veterinary ICU techs
When CVC educator Paula Plummer, LVT, VTS (ECC, SAIM), a feline internal medicine technician at the Texas A&M University Veterinary Teaching Hospital, created a list of common calculations used by ICU technicians, she included items she wished she’d had on hand her first day in the ICU.
The printable common calculations chart below includes drug calculations, whole blood transfusions (in cats), nutrition, fluids and infusions. While Plummer says that most of the calculations are straightforward, she offers a few tips on fluid rates.
“When you have a patient that needs to go on IV fluids, make sure you don’t just calculate its maintenance rate, which is 40 to 60 ml/kg per day—using the bottom end of the range for cats and the top end of the range for dogs,” she says.
These rates need to be adjusted based on the patient’s needs, says Plummer: “If you have a cardiac patient, you usually have to go a lot lower so you don’t fluid overload that patient due to their reduced cardiac output. And if your patient is dehydrated or has ongoing losses, you have to figure that into your maintenance rate to get an adequate rate to rehydrate your patient. To do this, you have to calculate the dehydration rate, and then if you have ongoing losses, you calculate that, and then you use all three of those numbers to get your 24-hour fluid rate—or sooner if you’re trying to rehydrate them or bolus them faster.”
Plummer also notes that if ICU technicians are going to do constant rate infusions (CRIs) that it’s ideal to keep them separate from the maintenance bag of fluids.
“I encourage technicians to run them separately if they have access to syringe pumps because as the patient becomes rehydrated, they won’t have to change out everything—they’ll only have to change the fluid rate on the IV pump,” says Plummer.