This lecture will provide a comprehensive guide on setting up an IV drip. Participants will learn the importance of IV therapy, the different types of IV fluids and equipment used, and the step-by-step process of setting up an IV drip. The lecture will also cover troubleshooting common problems and potential complications of IV therapy. By the end of the lecture, participants will have a thorough understanding of how to safely and effectively set up an IV drip.

1. Introduction to
Intravenous Therapy
Intravenous therapy is a precise and rapid way to deliver fluids
and medications directly into the bloodstream. It has
applications ranging from restoring blood volume to
administering drugs that cannot be given orally or need high
concentrations.
Dr. Shivankan Kakkar, M.D.

2. Types of Intravenous Fluids
Replacement fluids
Examples include isotonic
saline and ringer's lactate
solution.
Maintenance fluids
5% dextrose solution.
Special fluids
Examples includes
concentrated solutions of
glucose or potassium
chloride.

3. Fluid Types and Their Uses
Replacement Fluids
Similar osmolarity to
blood plasma
Used to correct fluid
deficits from vomiting
or diarrhea
Contains water and
electrolytes
Example: isotonic saline
(0.9% sodium chloride)
and ringer's lactate
solution
Maintenance Fluids
Mainly water and
glucose
Used to replace the
normal fluid losses
Example: 5% dextrose
solution
Special Fluids
Used for specific
indications like low
blood sugar or
potassium
Contains concentrated
solutions of glucose,
potassium chloride or
sodium bicarbonate
High osmolarity
Example: 25% dextrose
solution, injection
potassium chloride,
injection sodium
bicarbonate

4. Commonly used IV fluids are mentioned below
IV fluid Contents Pharmacological
basis
Indications Contraindications
Isotonic saline
(0.9%)
NaCl
0.9gm/100ml
Provides
extracellular
electrolytes and
increases
intravascular
volume.
·Dehydration in
diarrhea,vomiting
, excessive
perspiration
·Hypovolemic
shock.
·Hypertension
and congestive
cardiac failure
·Edemadue to
renal disease
and cirrhosis
Ringer’s lactate Sodium lactate
320 mg,
NaCl 600 mg,
KCl 40 mg and
CaCl2 27 mg/
100 ml
Aphysiological
solution, rapidly
expands
intravascular
volume.Sodium
lactate present is
metabolized into
bicarbonate in
liver.
·Rapid correction
of severe
hypovolemia
·Dehydration
associated with
metabolic
acidosis like
diarrhea
·Conditions with
impaired lactate
metabolism (liver
disease, severe
hypoxia)
5%
Dextrose
Glucose
5gms/100 ml
Corrects
intracellular
dehydration,
supplies energy
(170 Kcal/litre),
hypotonic to
plasma.
·Dehydration due
to inadequate
water intake or
excessive
waterloss
·IV
administrationof
drugs
·Diabetes mellitus
·Hypovolemic
shock
·Hyponatremia
Dextrose saline
(5% Dextrose
with 0.9% NaCl)
Glucose 5 gm and
NaCl 0.9gm/100
ml
Provides
extracellular
electrolytes and
energy.
·Dehydration due
to salt and water
depletion along
with supply of
energy.
·Hyponatremia

5. Benefits of Intravenous Therapy
Predictable
Rapid and predictable
effects are useful in
emergencies where time
is critical.
High dose
Accommodates high
doses of irritant or
hypertonic substances.
Large volume
Delivers large volumes of
fluid that are difficult to
ingest or inject.

6. Risks of Intravenous Therapy
1 Infection
Infection of the fluid or the insertion
site by bacteria or fungi can cause
phlebitis or sepsis.
2 Allergic reaction
Some individuals may experience fever,
rash, swelling, or even anaphylaxis.
3 Air embolism
Air bubbles can enter the bloodstream
cause chest pain, shortness of breath,
stroke, or cardiac arrest.
4 Fluid overload
The administration of more volume
than the body can handle can cause
swelling, hypertension, or heart failure.

7. Fluid Bag Information
Before setting up an intravenous fluid infusion, you need to
check the fluid bag carefully. The bags may contain different
fluids, but they all have a similar structure and label.
• Fluid type
• Fluid expiry date
• Injection port
• Spike port

8. Equipment for administering an intravenous infusion

9. The Intravenous Therapy
Procedure
1. Greet and verify
Greet the patient and verify their identity and prescription
chart.
Check the fluid type, volume, and duration of
administration.
Ask about any allergies or contraindications.

10. The Intravenous Therapy
Procedure
2. Inform and inspect
Inform the patient about the purpose and benefits of the
IV therapy and obtain their consent.
Inspect the fluid bag for any signs of contamination or
damage such as leaks, discoloration, or particles. Discard it
if needed.
Remove the wrapper and place the fluid bag on a drip
stand.

11. Obtaining Informed Consent
Informed consent
Inform patients about
the risks, benefits, and
alternatives of
intravenous therapy.
Obtain written or verbal
consent.
Documentation
Record the details of the
informed consent process
in the patient's medical
record.
Communication
Encourage patients to
ask questions and
express any concerns
they may have.

12. The Intravenous Therapy Procedure
3. Connect and adjust
Tear open the pouch to remove the infusion set.
Close flow regulator.
Remove protector cap from piercing spike.
Insert the piercing spike to its full length into the top of the solution container.
Squeeze the drip chamber till it is half-filled.
Remove needle protector, holding the needle upright.
Open flow regulator & allow the solution to pass till all air bubbles in the tube are
removed.
Close the flow regulator.

13. The Intravenous Therapy
Procedure
4. Perform vein-puncture
Select a suitable vein for insertion, usually on the forearm
or hand.
Apply a tourniquet above the site and clean it with an
antiseptic swab.
Hold the needle at a 15-30 degree angle and insert it into
the vein with a quick thrust.
Release the tourniquet and secure the needle with tape or
dressing.
Attach the infusion set to the needle hub and open the
flow regulator gradually to achieve the desired flow rate.

14. Setting the Drip Rate
The drip rate is the number of drops of fluid that pass through the drip chamber every minute.
The drip rate controls the speed at which the fluid is infused into the patient. It can be
calculated using this formula:
First find the ml/hr needed:
• For example, 1 litre bag of normal saline to be given over 8 hours = 1000ml/8hrs =
125ml/hr
Then find the ml/min needed:
• For example, 125ml/hr = 125ml/60mins = 2ml/min
For a standard giving set, 20 drops equal 1ml. Therefore, you can find the number of drops
per minute:
• For example, 2mls/min = 40 drops/min

15. The Intravenous Therapy
Procedure
5. Monitor and document
Monitor the patient's vital signs, fluid intake and output,
and any signs of complications such as infiltration,
phlebitis, infection, or allergic reaction.
Document the procedure in the patient's chart, including
the date, time, type, volume, rate, site, and any
observations.

16. Preventing Complications
1 Hand hygiene
Clean your hands to reduce
the risk of infection.
2 Cannula care
Monitor the site for signs of
phlebitis or infiltration.
Change the cannulaif
needed.
3 Fluid administration
Administer fluids according to the prescribed rate and volume to
prevent overload or other complications.

17. The Importance of Fluid Balance
"Fluid balance is crucial for maintaining the homeostasis of the human body. Any deviation
from the normal range can lead to various health problems, from mild dehydration to
severe electrolyte imbalances or circulatory collapse. Intravenous therapy is one of the
options to correct fluid imbalances and restore the body's natural balance."
- Dr. Sarah Lee

18. Conclusion
Intravenous therapy is a valuable tool in patient care,
providing a precise and rapid method to deliver fluids and
medications directly into the bloodstream. While it has many
benefits, it also carries risks and complications. It's essential to
follow proper procedures and monitor the patient's response
to ensure the safe and effective use of intravenous therapy.