Intravenous Drug

Administration

 Intravenous injection
Injection made into a vein
Used when rapid absorption is called for, when fluid
cannot be taken by mouth, or when the substance to be
administered is too irritating to be injected into skin or
muscles

IV medication could be given as:

1. Push or Bolus
Administered
directly into the
vein
One time, rapid
injection of
medication into
the bloodstream

 2. In an IV line or
peripheral venous
catheter (PVC)
A slow drip of
medication over a set
period of time, to deliver
a constant amount of
therapy

Site of Injection
Hierarchy of Safety
1. Arms
2. Hands
3. Legs
4. Feet
5. Groin
6. Neck

 1st choice: Median cubital

vein- superficial
2nd choice: Cephalic veinShown in both forearm and
arm, it can be followed
proximally where it empties
into the axillary vein
3rd choice: Basilic vein Shown in the forearm and
arm, it divides to join the
brachial vein.

Materials
NEEDLES AND
SYRINGES
NEEDLE GAUGE, which
refers to the size of the
bore or hole in the
needle.
The higher the gauge,
the thinner the needle

 Most intravenous
injectors use either a
standard insulin set
which typically has a
27G or 28G needle
or a standard
tuberculin set with a
25G

Butterfly Needle

IV catheter

Tourniquet

IV Tubing

Parts

Macros
et

Microse
t

Soluset

BT Set

IV Fluids

IV Fluids

Complications Associated with IV

Catheters
Infiltration-leaking of
PhlebitisIV fluid into the tissue
surrounding the vein
1.
2.
3.
4.

Coolness of skin around catheter site

Taut skin
Swelling at area surrounding the IV
Inability to obtain blood return from
catheter
5. Pain or burning sensation at site

inflammation of the
walls of a vein
1.
2.
3.
4.
5.

Site is warm to touch

Reddish skin
Local swelling
Pain or burning sensation at site
Palpable cord along vein

PROCEDURE

Checklist from WHO: IV injection

Syringe with the drug to be administered (without air)
needle (Gauss 20, long and medium thickness; on
syringe)
liquid disinfectant
cotton wool
adhesive tape
tourniquet

 1. Wash your hands.

2. Reassure the patient and explain the procedure.
3. Uncover arm completely.
4. Have the patient relax and support his arm below the
vein to be used.
5. Apply tourniquet and look for a suitable vein.
6. Wait for the vein to swell.

 7. Disinfect skin.
8. Stabilize the vein by pulling the skin taut in the
longitudinal direction of the vein. Do this with the hand you
are not going to use for inserting the needle.
9. Insert the needle at an angle of around 35 degrees.
10. Puncture the skin and move the needle slightly into the
vein (3-5 mm).
11. Hold the syringe and needle steady.
12. Aspirate. If blood appears hold the syringe steady, you
are in the vein. If it does not come, try again.

 13. Loosen tourniquet.

14. Inject (very) slowly. Check for pain, swelling,
hematoma; if in doubt whether you are still in the vein
aspirate again!
15. Withdraw needle swiftly. Press sterile cotton wool
onto the opening. Secure with adhesive tape.
16. Check the patient's reactions and give additional
reassurance, if necessary.
17. Clean up; dispose of waste safely; wash your hands.

How to Start an IV Line

Sterile disposable gloves
Appropriate size "over-the-needle" IV catheter (typically 14 - 25 gauge)
Bag of IV fluid
Non-latex tourniquet
Sterile bandage or dressing
Gauze
Alcohol wipes
Medical tape
Sharps container
Sterile pad or paper (set small tools out on this to keep them close at
hand)

 Prepare the IV tubing.Next,

prepare the IV tubing by
suspending the IV bag from an
elevated stand, filling the tubing
with saline solution, and checking
for any bubbles.
Choose a suitable-guage
catheter for the situation
Look for prominent veins.
Apply a tourniquet.

 Palpate the vein if necessary.If you're having a hard

time finding suitable veins, it can be helpful to palpate
the patient's skin in the area of the IV site.
Disinfect the IV site.
Prepare the catheter for insertion.Remove the
catheter from its sterile packaging. Briefly inspect it to
ensure that it is intact and working

 Insert the needle.Use the

non-dominant hand to stabilize
the patient's limb with gentle
pressure, taking care not to
touch the IV site directly. Take
the catheter in your dominant
hand and insert the needle
(bevel facing up) through the
skin. Reduce the angle of
insertion as you advance the
needle into the vein
Remove and discard the
needle

 Remove the needle and

insert the tubing.Hold onto
the catheter hub with your
thumb and index finger. Keep it
securely seated in the vein.
Secure the IV.Finally, secure
the IV against the patient's
skin. Place a piece of tape over
the catheter hub, then make a
loop in the catheter tubing and
tape this down with a second
piece of tape over the first

 Check the flow of fluid

into the IV.Open the IV
roller clamp and look for
drips forming in the drip
chamber.