Buretrol Basics 101

So I was asked if I knew how the buretrol worked because my preceptor could see I was fumbling with it, I gave her a hesitant "yes..." to which she responded, "Do I intimidate you?" Of course I responded in the negative when I probably should have said "Yes, all of my preceptors intimidate me."  I digress.

So here is what I know about the Buretrol.  Feel free to add your own comments below. You have probably all seen this contraption during your heart rotation (maybe this is more for myself and my posterity).  They are more commonly used for pediatric patients to limit the amount of fluid given to peds. I also read that they were used before pumps were available.

At the heart institute we give amicar and protamine through the buretrol. The buretrol should never be turned upside down. Also, if you want to draw fluid from tubing below the buretrol you must go very slowly otherwise it will pull a fair amount of air into the tubing. It is a better idea to just get fluid from another line if one is available. To empty the buretrol (and not withdraw fluid from the bag above) clamp the tubing between the bag and the buretrol and open the vent on the top of the buretrol making sure the tubing distal to the buret is unclamped. To fill the buretrol you can either inject directly into the buret through the male luer lock on top or open the vent and allow fluid to run from the IV bag to the buret with the tubing clamped distal to the buret.

I know this isn't rocket science but there you have it... Buretrol Basics 101.