How to Administer IV Fluids
Make sure you have an IV stand., Wash your hands., Double check that you have the right IV bag(s)., Determine what kind of set you will need to use., Get the right size of needle., Gather your other supplies.These include a tourniquet (to help...
Step-by-Step Guide
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Step 1: Make sure you have an IV stand.
The IV stand is the tall coat hanger-like device that you will hang the IV bag on when you are preparing and administering it.
In case you can’t find an IV stand and it is an emergency, your will have to hook the bag up to a place that is above the patient’s head, so that the force of gravity helps the liquid to flow downward into the person's vein. -
Step 2: Wash your hands.
Turn the faucet on and lather your hands with soap and water.
Start with your palms and work to the back of your hands.
Make sure that you also clean the areas between your fingers.
The next step is to focus on washing from your fingers to your wrists.
Finally, rinse thoroughly and pat your hands dry.
If there is no water source, rub your hands with an alcohol-based hand sanitizer., It is always important to check the doctor’s orders again before you begin.
Giving a patient the wrong IV bag could lead to a life-threatening situation, such as an allergic reaction.
You should double check that you are giving the medication to the right patient, that you are doing it at the right date and time, that you are giving the correct medication in the correct order, and that the bag is the right volume.
If you have any questions at all, it is important that you ask the doctor before continuing so that you are 100% sure you understand what you are supposed to do. , A set is the tube and connector that regulate how much fluid the patient will get.
A macroset is used when you are supposed to give the patient 20 drops per minute, or about 100 mL per hour.
Adults generally receive a macroset.A microset is used when you want to give the patient 60 drops of IV fluid per minute.
Infants, toddlers, and younger children generally need a microset.
The size of the tubing (and the size of needle) that you use will also depend on the purpose for the IV.
If it is an emergency situation where the patient needs fluids as quickly as possible, you will more likely choose a larger needle and tube in order to deliver the fluids and/or blood products or other medications as quickly as possible.
In less urgent situations, you may choose a smaller needle and tubing. , The trick here is that the higher the needle gauge, the smaller the size of the needle. 14 is the largest and it is usually used to correct symptoms of shock and trauma. 18-20 is the usual kind of needle used by adult patients. 22 is usually used on pediatric patients (such as infants, toddlers, and young children) or geriatric patients with ., Always wear gloves for standard protection against blood and body fluid exposure. , When the time comes to give the patient the IV, you will want to have all of your supplies right there.
This will ensure that the procedure as quick and easy as possible. , Look at the bag and locate the port of entry (this is located at the top of the IV bottle and is similar to a bottle cap).
The port of entry is also where the macroset or microset line will be inserted.
Unwrap an alcohol swab to sanitize the port of entry and the surrounding area of the bag.If you ever get confused while assembling the IV bag, there should be instructions written on the bag that you can follow.
However, if you have any questions, stop what you're doing and find someone who knows what to do. , Ensure that the drip chamber is in place (this is the part of the IV line that collects the fluid going through the patient’s vein).
This is also the part where medical personnel are able to regulate the IV to make sure the patient gets the right medication.
IV pumps, or infusion pumps, are often used to help deliver a precise dose for the proper amount of time. , Make sure that the drip chamber is half filled.
Once it is half filled, let the fluid in the IV flow until it reaches the end of the line (this is to remove any air bubbles are are trapped in the line).
Close it when it reaches the end by clamping the tube.
This is also termed as priming the tubing.
This is an essential step, as inserting an air bubble into the patient could be fatal. , The IV is sterile (as in it does not have any bad microorganisms on it).
If the line touches the floor, the fluid in the IV could be compromised (meaning bad microorganisms could get into it and infect the patient).If the IV line does touch the floor, you will have to prepare a new IV, as the contaminated IV could potentially harm your patient.
Keep the IV line close so that it does not touch the floor again. , Be courteous, introduce yourself and tell him that you will be the one administering his IV fluids.
It's best to lay all of the facts out for your patient — the needle puncturing his skin will hurt.
Try to describe it so that he knows what he is getting into., Wash your hands again to ensure extra cleanliness before putting on your gloves — this can also help reassure the patient that you care about her health and protecting her against unnecessary exposure to bacteria.
Lying or sitting calms the patient down and actually reduces the amount of pain she will feel.
It also ensures that she is in a stable position where she won't pass out if she has a psychological fear of needles. , The cannula is the tube-like structure that you will insert at the same time as the needle, but it will stay in place after you take the needle out.
You should look for a vein on the non-dominant arm (the one the person doesn't write with).
You should look for a long, dark vein that you will easily be able to see when you are inserting the needle.Start by looking for veins lower down on the arm, or even on the back of the hand.
Starting lower down will give you more "chances" if you are not successful at inserting the IV on your first try.
If you need to try a second time, you will need to move higher up the arm, so there are benefits to trying lower down first if you can find a reasonably visible vein.
You can also look for veins that are located in the crease where the forearm meets the upper arm.
These are often the easiest to insert an IV into; however, if the patient bends his arm, this can block the IV. , When you tie the tourniquet, it will cause the vein to bulge, which will make it easier to see, and easier to insert the needle into. , Use an alcohol swab to clean the insertion site (the spot that you will be putting the needle into).
Use a circular motion when you clean the spot so that you get rid of as many microorganisms as possible.
Let the area dry.Do not wave your hand over the area as if to dry it, as this can causes bacteria to be waved over the "cleaned area".
Instead, allow the alcohol to air dry. , Position the cannula so that you are holding it at a 30–45 degree angle to the patient’s arm and vein.
Hold the cannula like you would hold a syringe so that you do not accidentally pass it through the vein.
When you feel a “pop” and dark blood appears inside the cannula, decrease the angle of insertion so it is parallel to the patient’s skin.If this is your first time you are attempting this procedure, make sure you are doing so under supervision.
Push the cannula forward another 2mm.
Then fix the needle and push the rest of the cannula in a little bit further.Remove the needle fully.
Apply pressure above insertion site while maintaining site and connect tubing, otherwise the patient may bleed.
Dispose of the needle in a designated sharps container.
Finally, untie the tourniquet and clean the insertion site where the cannula is sticking out of the skin with a hypoallergenic dressing or alcohol swab. , You should do this by slowly feeding the tubing into the cannula until you can connect it.
Make sure that it is secure once it is connected.
Slowly open the line so that the IV fluid goes into the tube and into the patient.
You should also put tape on the tubing so that it stays in place on the patient’s arm.
Start by administering normal saline in order to ensure the IV is open and unobstructed.If you notice swelling in the surrounding tissue, or other problems with fluid administration, stop the saline flush and immediately remove the cannula.
You will need to start the process over again.
Assuming that the saline flows normally through the IV access you have set up, you can proceed to administering what the doctor has specifically ordered through the IV. , Regulate the IV drip rate according to the physician’s order.
Usually in a clinic or hospital, the physician will order a specific rate, like milliliters per hour.
In a field setting, you will need to do this manually.
The IV may have roller clamps and you need to count the drops per minute.
Other IV sets already have a roller knob that you can turn and set the drops per minute so that you don’t have to count. , Check your patient’s heart rate, respiratory rate, blood pressure and temperature.
Report any untoward signs and symptoms.
These symptoms could include an elevated heart rate, respiratory rate, difficulty breathing, hives, anaphylactic shock, or an increase in temperature and high blood pressure. -
Step 3: Double check that you have the right IV bag(s).
-
Step 4: Determine what kind of set you will need to use.
-
Step 5: Get the right size of needle.
-
Step 6: Gather your other supplies.These include a tourniquet (to help locate the vein you will insert the needle into)
-
Step 7: tape or medical adhesives (to keep all of the equipment in place once the needle is inserted)
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Step 8: alcohol swabs (to sterilize the equipment)
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Step 9: and labels (to keep track of the time of administration
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Step 10: the type of IV fluid
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Step 11: and the person who inserted the IV line).
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Step 12: Put all of your supplies on a tray.
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Step 13: Prepare the IV bag.
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Step 14: Pipe or insert the macroset or microset through the IV bag then hang it on the IV stand.
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Step 15: Get rid of any air bubbles in the line.
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Step 16: Make sure the line does not touch the floor because the floor is not sterile and could have bad bacteria on it.
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Step 17: Approach the patient.
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Step 18: Position the patient and put on your gloves.Ask the patient to sit or lie down on the medical bed or chair
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Step 19: whichever she prefers.
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Step 20: Look for the best place to insert the cannula.
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Step 21: Tie the tourniquet directly above where you will be inserting the needle.Tie it in a manner that will allow you to loosen it quickly.
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Step 22: Clean the spot where you will insert the cannula.
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Step 23: Insert the cannula.
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Step 24: Connect the IV tubing to the cannula hub.
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Step 25: Regulate the drops per minute.
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Step 26: Monitor your patient for any signs of an adverse reaction.
Detailed Guide
The IV stand is the tall coat hanger-like device that you will hang the IV bag on when you are preparing and administering it.
In case you can’t find an IV stand and it is an emergency, your will have to hook the bag up to a place that is above the patient’s head, so that the force of gravity helps the liquid to flow downward into the person's vein.
Turn the faucet on and lather your hands with soap and water.
Start with your palms and work to the back of your hands.
Make sure that you also clean the areas between your fingers.
The next step is to focus on washing from your fingers to your wrists.
Finally, rinse thoroughly and pat your hands dry.
If there is no water source, rub your hands with an alcohol-based hand sanitizer., It is always important to check the doctor’s orders again before you begin.
Giving a patient the wrong IV bag could lead to a life-threatening situation, such as an allergic reaction.
You should double check that you are giving the medication to the right patient, that you are doing it at the right date and time, that you are giving the correct medication in the correct order, and that the bag is the right volume.
If you have any questions at all, it is important that you ask the doctor before continuing so that you are 100% sure you understand what you are supposed to do. , A set is the tube and connector that regulate how much fluid the patient will get.
A macroset is used when you are supposed to give the patient 20 drops per minute, or about 100 mL per hour.
Adults generally receive a macroset.A microset is used when you want to give the patient 60 drops of IV fluid per minute.
Infants, toddlers, and younger children generally need a microset.
The size of the tubing (and the size of needle) that you use will also depend on the purpose for the IV.
If it is an emergency situation where the patient needs fluids as quickly as possible, you will more likely choose a larger needle and tube in order to deliver the fluids and/or blood products or other medications as quickly as possible.
In less urgent situations, you may choose a smaller needle and tubing. , The trick here is that the higher the needle gauge, the smaller the size of the needle. 14 is the largest and it is usually used to correct symptoms of shock and trauma. 18-20 is the usual kind of needle used by adult patients. 22 is usually used on pediatric patients (such as infants, toddlers, and young children) or geriatric patients with ., Always wear gloves for standard protection against blood and body fluid exposure. , When the time comes to give the patient the IV, you will want to have all of your supplies right there.
This will ensure that the procedure as quick and easy as possible. , Look at the bag and locate the port of entry (this is located at the top of the IV bottle and is similar to a bottle cap).
The port of entry is also where the macroset or microset line will be inserted.
Unwrap an alcohol swab to sanitize the port of entry and the surrounding area of the bag.If you ever get confused while assembling the IV bag, there should be instructions written on the bag that you can follow.
However, if you have any questions, stop what you're doing and find someone who knows what to do. , Ensure that the drip chamber is in place (this is the part of the IV line that collects the fluid going through the patient’s vein).
This is also the part where medical personnel are able to regulate the IV to make sure the patient gets the right medication.
IV pumps, or infusion pumps, are often used to help deliver a precise dose for the proper amount of time. , Make sure that the drip chamber is half filled.
Once it is half filled, let the fluid in the IV flow until it reaches the end of the line (this is to remove any air bubbles are are trapped in the line).
Close it when it reaches the end by clamping the tube.
This is also termed as priming the tubing.
This is an essential step, as inserting an air bubble into the patient could be fatal. , The IV is sterile (as in it does not have any bad microorganisms on it).
If the line touches the floor, the fluid in the IV could be compromised (meaning bad microorganisms could get into it and infect the patient).If the IV line does touch the floor, you will have to prepare a new IV, as the contaminated IV could potentially harm your patient.
Keep the IV line close so that it does not touch the floor again. , Be courteous, introduce yourself and tell him that you will be the one administering his IV fluids.
It's best to lay all of the facts out for your patient — the needle puncturing his skin will hurt.
Try to describe it so that he knows what he is getting into., Wash your hands again to ensure extra cleanliness before putting on your gloves — this can also help reassure the patient that you care about her health and protecting her against unnecessary exposure to bacteria.
Lying or sitting calms the patient down and actually reduces the amount of pain she will feel.
It also ensures that she is in a stable position where she won't pass out if she has a psychological fear of needles. , The cannula is the tube-like structure that you will insert at the same time as the needle, but it will stay in place after you take the needle out.
You should look for a vein on the non-dominant arm (the one the person doesn't write with).
You should look for a long, dark vein that you will easily be able to see when you are inserting the needle.Start by looking for veins lower down on the arm, or even on the back of the hand.
Starting lower down will give you more "chances" if you are not successful at inserting the IV on your first try.
If you need to try a second time, you will need to move higher up the arm, so there are benefits to trying lower down first if you can find a reasonably visible vein.
You can also look for veins that are located in the crease where the forearm meets the upper arm.
These are often the easiest to insert an IV into; however, if the patient bends his arm, this can block the IV. , When you tie the tourniquet, it will cause the vein to bulge, which will make it easier to see, and easier to insert the needle into. , Use an alcohol swab to clean the insertion site (the spot that you will be putting the needle into).
Use a circular motion when you clean the spot so that you get rid of as many microorganisms as possible.
Let the area dry.Do not wave your hand over the area as if to dry it, as this can causes bacteria to be waved over the "cleaned area".
Instead, allow the alcohol to air dry. , Position the cannula so that you are holding it at a 30–45 degree angle to the patient’s arm and vein.
Hold the cannula like you would hold a syringe so that you do not accidentally pass it through the vein.
When you feel a “pop” and dark blood appears inside the cannula, decrease the angle of insertion so it is parallel to the patient’s skin.If this is your first time you are attempting this procedure, make sure you are doing so under supervision.
Push the cannula forward another 2mm.
Then fix the needle and push the rest of the cannula in a little bit further.Remove the needle fully.
Apply pressure above insertion site while maintaining site and connect tubing, otherwise the patient may bleed.
Dispose of the needle in a designated sharps container.
Finally, untie the tourniquet and clean the insertion site where the cannula is sticking out of the skin with a hypoallergenic dressing or alcohol swab. , You should do this by slowly feeding the tubing into the cannula until you can connect it.
Make sure that it is secure once it is connected.
Slowly open the line so that the IV fluid goes into the tube and into the patient.
You should also put tape on the tubing so that it stays in place on the patient’s arm.
Start by administering normal saline in order to ensure the IV is open and unobstructed.If you notice swelling in the surrounding tissue, or other problems with fluid administration, stop the saline flush and immediately remove the cannula.
You will need to start the process over again.
Assuming that the saline flows normally through the IV access you have set up, you can proceed to administering what the doctor has specifically ordered through the IV. , Regulate the IV drip rate according to the physician’s order.
Usually in a clinic or hospital, the physician will order a specific rate, like milliliters per hour.
In a field setting, you will need to do this manually.
The IV may have roller clamps and you need to count the drops per minute.
Other IV sets already have a roller knob that you can turn and set the drops per minute so that you don’t have to count. , Check your patient’s heart rate, respiratory rate, blood pressure and temperature.
Report any untoward signs and symptoms.
These symptoms could include an elevated heart rate, respiratory rate, difficulty breathing, hives, anaphylactic shock, or an increase in temperature and high blood pressure.
About the Author
Ruth Brooks
Dedicated to helping readers learn new skills in hobbies and beyond.
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