Medications put in the additive section of the fluid calculator are NOT counted towards inventory. However, adding fluid additives in the "Medication" section of the flowsheet can result in an inaccurate medical record (i.e when it looks like you have given the medication as a bolus vs. a dose). Following these steps will ensure that your additives are tracked effectively.
We suggest creating a 'Route' called 'Added to Bag'. This way, we can avoid fluid additives being mistaken for fluid boluses on the medical record.
Open up any medication and in the 'Route' section where you would normally select from the drop-down list, click in the 'Search' bar and type in 'Added to Bag' (see screenshot below).
Enter the volume of the medication you'll be adding to the bag in the "ml" box here:
This way, it is a clearly indicated that although the medication will be administered IV (as an additive to the fluids), it will not be given directly to the patient at that time. It is also displayed clearly on the flowsheet (as seen in the screenshot below). The cell is to be initialed after the medication has been added to the bag of fluids.
Each medication within the bagged drug cocktail (i.e Morphine, Lidocaine, Ketamine) should be added to the medication section of the flowsheet individually, with the volume of drug shown and 'Route' indicating 'Added to Bag'.
Because the additives section is limited to one line on the iPad, if you're creating a multiple-drug cocktail, you may want to create a fluid named accordingly. If you're only adding one additive, you can just use your regular fluid (LRS) and add the additive there.
Let's walk through MLK as an example:
To track the dose rate of your bagged drug cocktail, create a new fluid called 'MLK' (you may need to contact your clinic admin to do so) add the information about each additive in the 'Additives' section (see screenshot below).
The medical records for this patient's flowsheet will appear as follows:
After tracking fluid rates and adding more medications to the bag to increase the dosage, we can see that on the medical record as well:
When the dosage is changed on the flow sheet, highlight that cell to show a change was made:
These medications will show up on the billing sheet with appropriate volumes, for inventory control:
If you don't want them to come across as billable items, you can see THIS FAQ on how to turn off Billing.