Charting an IV Treatment

The IV builder records what actually went into the bag: the diluent, every component with its dose and lot, the calculated osmolarity, and the administration details. When the treatment is administered it posts the charges, moves the stock and writes the record into the chart note.

Open the panel:

• Open the encounter and start or edit a chart note.
• Find IV Therapy in the sidebar. If it is not there, the segment has not been attached to this note's section yet.
• Click + New IV, or pick a protocol from the list to start from a formulation.

Build the bag:

1. Choose the diluent and its volume - the carrier the additives go into.
2. Add each component by searching for it. Type a dose and the volume is worked out for you; type a volume and the dose is worked out instead. Whichever you typed last is the one kept, and the derived figure is shown in a lighter weight so it is clear which is which.
3. Record the lot number and expiration date for each component. A lot past its expiration date is flagged immediately.
4. Set the route (infusion or IV push), access (peripheral, central or port), site, rate and duration.

Read the osmolarity: the summary updates as you type and bands the result - under 500 mOsm/L is within the range routinely given peripherally, 500 to 900 is peripheral with caution, and above 900 indicates central access. If any component has no osmolarity on file the figure is marked as a lower bound rather than a final number.

These are osmolarity bands, not tonicity. A bag at 280 mOsm/L is not therefore "isotonic": dextrose counts fully toward osmolarity and is then metabolised, so D5W is iso-osmolar and hypotonic. The module reports the number it can calculate and does not infer tonicity from it.

Administer: this is the only step that cannot simply be undone, and it confirms first. It stamps the start time, marks the treatment administered, posts the charges, decrements stock and inserts the record into the note. If the calculated osmolarity indicates central access but peripheral access is selected, you are asked to acknowledge that explicitly and the reason is recorded.

What reaches the encounter: each billable component becomes its own service line carrying its billing code and the correct number of units, alongside any administration lines the protocol defines. Stock is decremented for every mapped component. Clicking Administer twice does not double-post - the second click does nothing.

The note: the inserted block is the full compounding and administration record - components with doses, lots and expirations, total volume, osmolarity with its band, beyond-use date, route, access, site, rate, start and stop times, and who administered it.

A compounded bag has a beyond-use date, which is how long the mixture stays usable after it was prepared. That is a different thing from the expiration date printed on a vial as supplied, and both are recorded.