Intravenous Infusion
Table of Contents
Definition
Intravenous infusion is a method of giving fluids and nutrients directly into the body of a patient via a vein by means of a cannula or scalp vein needle.
Indications
- To replace water and electrolyte losses when other routes cannot supply as rapidly or efficiently as required.
- To supply the body with nutritional requirements such as glucose, amino acids, and protein hydrolysates when the patient is unable to take them orally.
- To supply one or more components such as plasma, plasma substitute, or cell suspensions.
- For the administration of some drugs.
Types of Fluids
- Normal saline (sodium chloride) 0.9% solution.
- Dextrose 5%.
- Hartman’s solution / Ringer’s lactate and ½ strength Darrow’s solution — contain additional electrolytes like potassium and calcium.
- Dextran solution — acts as a volume expander.
- Blood.
Commonly Recommended Veins
Back of the Hand
- Dorsal metacarpal veins: This site allows arm movement, and if a problem arises, another site can be chosen.
Forearm
- Basilic vein
- Cephalic vein
Inner Aspect of the Elbow (Antecubital Fossa)
- Medial basilic vein
- Median cephalic vein
- These veins are larger and can be entered more easily, but flexion of the elbow or movement may dislodge the needle. Always choose a site below the elbow crease.
Lower Extremity
- Femoral and saphenous vein in the thigh.
- Dorsal venous plexus, medial and lateral marginal veins in the foot.
Scalp Veins
These may be used in infants and elderly patients.
Procedure
- Explain the procedure to the patient.
- Screen the bed and put the patient in a comfortable position.
- If necessary, shave the infusion site.
- Support the patient’s forearm on a pillow covered with a mackintosh.
- Prepare the prescribed infusion fluid, checking for particles and expiry date before use.
- Attach the bottle holder if necessary.
- Remove the cap of the bottle and sheath from the piercing needle.
- Insert the piercing needle of the giving set into the rubber seal. If no air inlet is available, use another needle for an air vent.
- Allow fluid to run through the giving set until all air is expelled. Fill the fluid chamber halfway.
- Use a tourniquet or sphygmomanometer to locate the vein more easily.
- Ask the patient to open and close their fist to distend the veins.
- Gently tap and palpate the vein to check suitability.
- Clean the skin with antiseptic and insert the cannula or scalp vein needle into the vein. Once in place, release the tourniquet.
- Hold the vein steady while inserting the cannula at a 20–30° angle with the bevel facing upwards.
- Once the cannula is in the vein, stop advancing and lower the angle.
- Slide the cannula off the needle into the vein and apply pressure above the site to minimize bleeding.
- Connect the apparatus and regulate the flow rate with the clip.
- Clean any blood, apply a sterile dressing, and secure the cannula in place.
- Regulate the rate of flow as prescribed by the doctor.
- Record the date and time of starting the infusion and leave the patient comfortable.
Formula for Calculating Drop Rate
Formula:
(Number of ml × Drops per ml) ÷ (Number of hours × 60) = Drops per minute
Example Calculation
Example: The doctor has ordered 1000ml of 5% dextrose infusion to run in 10 hours. The infusion set has a drop factor of 20.
Calculation:
1000 × 20 ÷ (10 × 60) = 33.3 ≈ 33 drops per minute
If the rate is not specified, the normal rate is 40 drops per minute.
Disclaimer: This article is for educational purposes only and is not a substitute for professional medical advice. Always follow your healthcare institution’s protocols and consult a qualified professional before performing any procedure.
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