7- Intravenous (I.V) Infusion Définition: Administration of solution via peripheral or central veins.

7- Intravenous (I.V) Infusion Purposes: 1. To supply fluid when client are unable to take in an adequate volume of fluid by mouth. 2. To provide salts needed to maintain electrolyte balance. 3. To provide glucose the main fuels for metabolism.

7- Intravenous (I.V) Infusion 4. To provide water-soluble vitamins and medications. 5. To establish a lifeline for rapidly needed medications.

Equipment 1. Infusion set include: a. Insertion spike. b. A drip chamber. c. Screw clamp. d. Tubing with secondary port. e. A protective cap over the needle.

Equipment 2. Intravenous catheter: a. Over the needle catheter (angio caths). b. Butterfly (wing-tipped). 3. I.V. poles to hang the solution. 4. Container of sterile parental solution.

Equipment 5. Adhesive tape. 6. Tourniquet. 7. Clean gloves. 8. Antiseptic swab. 9. Sterile gauze dressing. 10. Arm splint. 11. Towel or pad. 12. Electronic infusion device or pump.

Wash your hand and assemble equipment. Procedure      Discuss the procedure with the client and the discomfort associated with vein puncture.      Wash your hand and assemble equipment.      Remove tubing from the container and straighten it out.

Remove the protective cover from the entry site of the bag. Procedure      Close the clamp. Leave the end of tubing cover with plastic cap until infusion is started. (To maintain sterility of the end of tube).      Remove the protective cover from the entry site of the bag.

6. Remove the cap from the spike & insert it into the site of the bag. Procedure 6.     Remove the cap from the spike & insert it into the site of the bag.

Procedure 7. The timing label applied at the time infusion is started to the bag. 8. Adjust the pole so that the container is suspended about 1 m above the client’s head. (This height is needed to enable gravity to overcome venous pressure and facilitate flow of solution into the vein).

Procedure 9.     Squeeze the chamber until it is half full of solution. (To prevent air from moving down the tubing).

Procedure 10. Remove the protection cap and hold the tubing over the container. Replace the clamp and let the fluid run through the tubing until all bubbles are removed. 11. Re clamp the tubing & replace cap maintaining sterile technique.

Procedure 12.     Wash your hand again and start to select the vein puncture site. a.      Place towel under the extremity to protect linens. b.     Place the extremity in a dependent position lower than heart level. (Gravity slows venous and distends the vein).

c. Apply a tourniquet firmly 15-20 cm above vein puncture site. Procedure c.     Apply a tourniquet firmly 15-20 cm above vein puncture site. d.     Encourage client to clench and unclench his fist with massage or stroke the vein.

Procedure e. The preferred infusion sites include: - Metacarpal vein . - Basilica vein. - Cephalic vein

Procedure 13. Don the gloves and clean the skin at the site of entry with antiseptic swab using circular motion moving from center outward. Permit the solution to dry on the skin.

Procedure 14. Grasp the extremity and apply traction to the skin distal to the insertion site. (This helps to stabilize the vein wall and less painful penetration).

Procedure 15. Holding the over-the-needle at 15-30 degree angle with bevel up. Insert the catheter through the skin and into the vein.

Procedure 16. Once blood appears in the lumen of the needle, reduce the angle of catheter until it is almost parallel with the skin and advance and catheter 1 cm further until the hub is at the vein puncture site.

Procedure 17. Replace the tourniquet. Remove the protective cap from distal end of the tubing and hold it ready to attach to the catheter. 18. Remove the needle and attach the end of the infusion tubing to the catheter hub.

Procedure 19. If a Butterfly is used: a. Hold the needle with the bevel up and enter the skin, lower the needle so that it is closer to the client’s skin and advance the needle in the direction of the vein (Lowering the needle reduce chances of puncturing both sides of the vein).

Procedure b. When the blood flows back into the needle tubing, insert the needle to its hub. c. Release the tourniquet, attach the infusion and initiate flow. .

Tape the catheter by “ U “ method by using 3 strips of adhesive tapes: Procedure Tape the catheter by “ U “ method by using 3 strips of adhesive tapes: a.      One placed under the catheter’s hub, then fold each end over so that the sticky side against the skin.

Procedure

Procedure b. Second strip over the catheter hub. c. Third strip over tubing hub. 21. For securing a Butterfly needles; tape the needle securely by the crisscross method. Place small gauze under the needle if required to keep the needle in position in the vein.

Procedure

Procedure 22. Remove soiled gloves and discard it appropriately. 23. Loop the tubing and secure it with tape. (To prevent pulling on needle or catheter). 24. Labeling the dressing with the date and time of insertion, type and gauge of needle.

Procedure 25. Apply a padded arm board to splint the joint as needed. 26. Adjust the infusion rate of flow and label the tubing with the date & time of attachment and your initial. (To ensure that it is changed at regular intervals 24 to 72 hours).

Procedure 27. Record the start of infusion on client chart. Include date, time of vein puncture, amount and type of solution, flow rate and the client general response.

8- Discontinuing An Intravenous Infusion Purpose: To safely terminate an intravenous infusion when therapy has been accomplished. Equipment: 1. Clean gloves. 2. Sterile gauze pads. 3. Adhesive tape or bandage. 4. Swabs.

Procedure 1. Check physician’s order for termination of infusion. 2. Wash hands. 3. Discuss the procedure with the client, including the reason, the anticipated benefits and the desired participation.

Procedure 4.     Close roller clamp on I.V (To prevent solution from flowing over linens, client and caregiver when vein puncture device is withdrawn from vein).

Procedure 5. Remove all tape from I.V tubing and arm board. Carefully remove tape securing the vein puncture device while holding device stable with opposite hand. (Prevents pain and site trauma as tape is being removed). 6. Don clean gloves. (To prevent contact with client blood, which may be pathogens

Procedure 7. Cover inserted site with sterile gauze and apply pressure to site, while carefully withdrawing the veinpuncture device. Apply pressure at insertion site until bleeding stops, usually 2 to 3 minutes. 8. Discard soiled gauze in infectious wastes container and apply dry, sterile gauze dressing or adhesive bandage. (To protect puncture site during heading).

Procedure 9. Dispose I.V equipment according to hospital policy. 10. Record time the I.V is discontinued, state of puncture site and cannula State.