Why are standard concentrations safer than using the Rule of 6 for pediatric drips?
While nurses and house staff may find the Rule of 6 convenient, we’ve previously written about problems with its use (in our June 12, 1999 issue). First, the Rule of 6 is used primarily for nursing IV admixture, an at-risk procedure that bypasses pharmacy preparation and subsequent double-check systems. Additionally, some medications, such as dopamine, may be available in vials of varying concentrations, increasing the risk of an error. Next, a mathematical calculation is required, which is always an error-prone process if done manually. Obtaining an accurate weight has been a challenge in hospitals that have asked pharmacy to use the Rule of 6 to prepare solutions for nurses. Inconsistency has resulted in problems, too. People who use the Rule of 6 may assume that all solutions dosed in mcg/kg/minute are prepared in this fashion. If a different concentration is used, infusion rates may be adjusted incorrectly. Another concern is that solutions prepared using the Rule of 6 may result i
