Harriet Lane Infusion Calculator

The Harriet Lane Infusion Calculator has been developed to aid providers at the Johns Hopkins Hospital in the ordering of medications drips. While we believe that this tool will help to reduce provider errors and with it adverse drug events at our institution, by no means can this tool replace the diligence and attention to detail by our residents, fellows, physician assitants, nurse practitioners, pharmacists and attendings. Please use good judgement when applying this tool.

First Screen:

Please enter your patient's weight (in KG).
Select the drip(s) you would like to order. You can order as many as four drips at once. If you need to order drips in excess of four medications, you will have to repeat the process.

Second Screen (with "Calculate" Button):

Here you have again the opportunity to enter your patient's weight.
If the patient is a PICU patient AND has a central line, you may select "PICU Patient" to allow for more concentrated drips.
Select your Carrier Fluid: You can either use the pulldown menus to select a Dextrose AND/OR Sodium solution or you may use the text boxes to the left of the pulldown menu to type a carrier fluid. Some drugs (Example: Na Bicarb, Heparin and Insulin) come with preselected carrier fluids.
Select the amount of fluid. Don't worry about choosing too little fluid. If your drip would run out before 24 hours are over, you will be alerted on the next page.
Select the dose for your medication.
Some medications will allow you to change the flow rate (please be in compliance with the minimum required flow rate on your unit), others that are based on ready to use concentrations do not allow a change in the flow rate, which is calculated by the computer.
Press "Calculate"

Third Screen (with "Printable Screen" Button):

If you forgot to enter your patient's weight, you will have no other option but to go "BACK" and enter it.
If you forgot to enter a carrier fluid (dextrose of Na), a purple reminder will show next to the drip that still needs a carrier fluid. You will have no other option but to go "BACK" and enter it.
Alerts:
Most likely you will see some alerts. They are discussed in detail below:
- Maximum allowed concentration: The selected dose and infusion rate would result in a drug concentration that exceeds the maxiumum allowed concentration. No response is needed, the program recalculated the infusion rate based on the dose. You might want to consider to go back and check PICU patient if your patient is in the PICU AND has a central line since this will alter the allowed maximum concentrations.
- Insufficient volume: If you selected a volume that is too low to sustain the infusion rate for 24 hours, you will receive an alert. You may want to consider to go back and alter the volume.
- Maximum recommended dose: If your selected dose exceeds the maximum recommended dose you will receive this alert. You may select to override this alert.
- Fluid volume: If your infusion rate exceeds 100 mL/kg/day, you will receive an alert.
Enter your name and JHU Physician ID number
Press "Printable Screen"

Fourth Screen (Final Order):

Print two copies of this page: one copy for the chart and the other copy for pharmacy.
Stamp each order with the patient information.
Sign each order

Questions, Comments, Suggestions? Email Chris Lehmann, MD.

HELP / Instructions
© 2005, Johns Hopkins University, Department of Pediatrics, Christoph U. Lehmann, M.D. & Michael Veltri, Pharm.D.