ADMINISTERING AN INTRAVENOUS INJECTION

DEFINITION Intravenous injection is administration of medication into the veins. SITES OF INTRAVENOUS INJECTION Sites commonly used are the 1. 2. 3. 4. 5. Veins in ante cubital (median cubical, cephalic and basilica veins) Veins in hand (dorsal meta carpel veins) Veins of forearm (basilic and cephalic vein) Femoral and saphenous vein Veins in radial area (radial veins)

ARTICLES A clean tray containing, 1. Mackintosh and towel 2. Clean gloves (optional) 3. Spirit 4. Disposable syringe 5ml or 10ml with needles 5. Sterile Cotton swabs and gauze pieces in a bowl 6. Medications in vial or ampoule 7. Medication card 8. Kidney tray 9. Tourniquet 10. Adhesive tapes 11. Small steel tray PROCEDURE S.NO 1 2 3 4 5 6 7 STEPS Check the physicians order Identify the patient Explain the procedure to patient Wash hands and put on clean gloves Prepare the medication from ampoule or vial and keep it in steel tray Spread mackintosh with towel under the site Select and examine the veins, RATIONALE Ensures co-operation from patient To prevent infection and avoid getting blood in hands

To prevent soiling of linen Select a vein that is visible, palpable

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visualize the vein, including the antecubital area, wrist, dorsum (back) of the hand and top of foot (if necessary). Choose the appropriate wide vein to be drawn by touching the skin over the vein in a circular motion. Instruct the patient to extend his arm. Hold the arm straight at the elbow with fist clenched. Apply the tourniquet 5 to 15cms above the selected site with just sufficient pressure to obstruct venous flow Cleanse the skin with alcohol swabs (or betadine if alcohol is not available) in a circular motion; centre to periphery. Allow to dry it. Fix chosen vein with thumb and draw the skin taut immediately below the site before inserting the needle to stabilize the vein. Hold the syringe between the thumb and last three fingers with the bevel up and directly in line with the course of the vein. Insert the needle quickly and smoothly under the skin into the vein Gently pull back the plunger and see blood is coming back and seen in the barrel Release the tourniquet as soon as possible. Inject the medicines into the vein slowly. Apply sterile gauze piece to puncture site without applying pressure and withdraw needle slowly along the line of vein Request patient to apply gentle but firm pressure to site for 2-4 minutes

and fixed to the surrounding tissues so that it does not roll away

Proper positioning visualization of veins

increases

the

A tourniquet when applied increases venous pressure and makes the vein more prominent and easier to enter Cleansing the skin reduces number of micro organism the

The vein may slip and move under the skin when the needle approaches its outer surface, especially in elderly, extreme thin patient and diabetic patient.

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To confirm the needle is in vein.

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Immediate pushing of medicine may cause discomfort to patient Slow withdrawal of the needle is less painful and reduces trauma

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Dispose the needle and syringe in appropriate containers Replace the tray with the reusable

Firm pressure over puncture site prevents leakage of blood into surrounding tissues with subsequent hematoma development Avoids possible spread of blood borne disease

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articles in proper place Assist the client to a position of comfort Remove your gloves and perform hand hygiene Record the medication administered, dose, date, time, route of administration, and IV site on the appropriate form. Evaluation the clients response: Check the client's response to the medication within an appropriate time. Assess the site within 2 to 4 hours after administration

To facilitate comfort and make him/her relax To prevent the spread of infection Documentation provides coordination of care Site rotation prevents injury to muscle tissue Drugs administered parenterally have a rapid onset. Assessment of the site deters any untoward effects