COMMENCING ANINTRAVENOUS INFUSION By: Nelson Munthali, Dip/RN Date: 15th May 2012
Objectives1. Define intravenous infusion.2. Explain reasons for commencing intravenous infusion.3. Explain the indication for intravenous infusion.4. List down equipment required for intravenous infusion.5. Explain in steps how to commence an intravenous infusion.
Definition It is an introduction of fluids into the circulation through one of superficial veins of the forearm, scalp, elbow or ankle.
Objectives1. To supplement the body with fluids.2. To administer blood products, medication and nutritional components.3. To maintain intravenous routes.4. To maintain normal circulation volume.
Indication1. Failure to take enough food or fluids by mouth2. Failure to swallow e.g. unconscious patient.3. When it is undesirable to take food by mouth e.g. post operatively.4. To maintain and correct electrolytes when excess fluid is lost through diarrhea and vomiting.5. To keep the vein open for medication
EquipmentTop trolleyBowl of swabsCannulaReceiverGalipot with skin disinfectantA pair of sterile glovesSterile giving set
Bottom trolleyA mackintosh or towel padded splint to secure the arm or leg.A litre of solution to be usedTourniquetStrapping and scissorsFluid balance sheetReceiver for wasteLatex gloves e
Procedure1. Assemble all necessary equipment2. Move the trolley to patients bed side.3. Wash hands with soap and water4. Connect the giving set to the infusion bottle and suspend it on a drip stand.5. Expel air from the giving set and clamp it to avoid continuous overflowing of fluids.
6. Select the site for the insertion of the infusion.7. Put on clean gloves8. Apply tourniquet on the limb just above the site9. Swab the site with antiseptic.10.Hold the cannula on your dominant hand and with the non dominant hand secure and immobilize the vein.
11. Insert the cannula at an angle of 45 into the identified vein and make sure that blood is coming out.12. Release the tourniquet with the non dominant hand and withdraw needle slowly with the dominant hand13. Connect the infusion set to cannula.14. Secure the cannula with a plaster
15. Open the drip and let it run according to the prescribed rate.16. Splint and immobilize the limb if necessary.
DocumentationLabel the intravenous infusion bottle i.eType of solutionTime commencedTime of completionFlow rateMedication added if anyRecord on fluid balance sheet and sign for all.
Calculation of flow rateTotal amount of solution x Drop factorTime (hours x minute)= Drops / minutee.g. A doctor has prescribe to give 3000ml in 24hrs with a giving set drop factor of 20drops/min
3000 x 20 drops24 x 60 min= 42 drops / minuteNoteEvery giving set has a drop factor calculated from the factory and is labeled on the pack.
TAKING BLOOD SAMPLE Blood samples are taken for laboratory investigation.EquipmentAntiseptic swabs in a galipotSyringe with a needleReceiver for used swabsTourniquetGloves
Procedure1. Explain the procedure to patient.2. Assemble all necessary equipment3. Move the trolley to patients bed side.4. Label the specimen bottles.5. Wash hands with soap and water6. Select the site for the prick7. Put on clean gloves
8. Apply tourniquet on the limb just above the site to be pricked.9. Swab the site with antiseptic.10. Hold the syringe on your dominant hand and with the non dominant hand hold a dry swab and immobilize the vein.11. Prick the skin with the needle at an angle of 45 degrees and release the tourniquet when in vein 12. pull out the plunger to let blood collect in the syringe.
13. Withdraw the syringe when enough blood sample has been collected.14. Swab the pricked site with a dry swab.15. Prick the rubber top part of the specimen bottle with the needle to let blood move from the syringe into the specimen bottle by vacuum.16. Shake the bottle gently if collecting non clotted blood sample. Vigorous shaking breaks blood cells
17. Thank the patient and leave him/her comfortably.18. Wash hands after the procedure