Intravenous injections are administered directly into the blood via a vein. They do not need to be absorbed and have an immediate action.
Introduction
- Wash hands; Introduce self; Patient’s name, DOB and wrist band; Explain procedure and obtain consent
- Cannula check: check when inserted, for signs of phlebitis and any pain
- Allergy check: check for allergies with patient and on drug chart
- Prescription check: check the prescription drug and dose, and confirm the name and DOB are correct (check with patient and their wristband)
- Look up drug in Injectable Medicines book to determine volume of sterile water/saline required to reconstitute drug (if it is in powder form) and injection rate
Preparation
- Wash handsÂ
- Clean tray
- Gather equipment around tray (think through what you need in order)
- Gloves (+ extra pair and apron if you need to draw up drug/flush)
- Drug – CHECK DATE, DOSE, PRESCRIPTION AND ALLERGIES
- + if drug is in liquid form: blunt fill 18G drawing-up needle and syringe for drawing-up
- + if drug is in powder form: blunt fill 18G drawing-up needle, syringe and vial of sterile water/saline for reconstituting drug and drawing-up – CHECK DATE
- Alcohol 70%/chlorhexidine 2% device disinfection wipe
- + if cannula does not have cannula IV extension set: sterile gauze and replacement bung
- 2 x pre-prepared saline flushes (or 2 x: 10ml 0.9% saline + 10ml syringe + blunt fill 18G drawing-up needle) – CHECK DATE
- Wash hands
- Open packets and place neatly in tray, keeping items in plastic parts of packets (without touching the instruments themselves)
- If flushes are not pre-prepared:
- Wash hands, put on apron and extra pair of gloves
- Snap top off 0.9% salineÂ
- Put green needle on syringe, hold saline upside-down and draw up 10ml saline
- Dispose of needle in sharps bin
- Expel air from syringe and place back into syringe packet in tray
- Repeat the process for second flush
- Discard waste; then discard gloves and apron; wash hands (if not drawing up drug)
- If the drug is in powder form:
- Wash hands, put on apron and extra pair of gloves (or leave on previous ones if you had to prepare flush)
- Snap top off sterile water/saline vial
- Put drawing-up needle on syringe, hold sterile water/saline vial upside-down and draw up required amount for reconstitution (plus a bit extra)
- Expel air and some water from syringe to leave the exact amount needed for reconstitution
- Insert needle and inject the sterile water/saline. Twist the vial back and forth on end of needle until drug powder is fully dissolved.
- Draw up drug solution while the vial is upside-down
- Remove and dispose of drawing-up needle in sharps binÂ
- Expel air from syringe and place back into syringe packet in tray
- Discard waste; then discard gloves and apron; wash handsÂ
- If the drug is in liquid form:
- Wash hands, put on apron and extra pair of gloves (or leave on previous ones if you had to prepare flush)
- Put drawing-up needle on syringe and fill with approximately the same volume of air as in the drug vial if drug vial contains a vacuum
- Flick/snap top off drug vial
- Insert needle into the vial, and inject the air into the airspace if drug vial contains a vacuum
- Draw up drug solution while the vial is upside-down
- Dispose of drawing-up needle in sharps binÂ
- Expel air from syringe and place back into syringe packet in tray
- Discard waste; then discard gloves and apron; wash handsÂ
- Walk to patientÂ
Procedure
- Wash handsÂ
- Put on gloves
- If no cannula IV extension set on cannula:
- Place gauze under back of cannula
- Open back port of cannula while occluding the vein proximally
- Clean cannula back port with device disinfection wipe
- If cannula IV extension set on cannula:
- Holding the proximal part of the administration port of the cannula IV extension set, clean the port with the device disinfection wipeÂ
- Flush 5-10mls flush 0.9% saline through the cannula’s back port/IV extension set slowly (in a pulsating manner)
- Administer drug at rate stated in Injectable Medicines book
- Administer 2nd 5-10ml flush through the cannula’s back port/IV extension set slowly (in a pulsating manner)
- If no cannula IV extension set, place new cannula back port bung; if using cannula IV extension set, lock lumen
To complete
- Thank patient and restore clothing
- Discard waste and clean tray; then discard gloves; wash hands
- Sign on the drug chart that the drug has been administered
Try an OSCE station
- Intravenous injection
- Find lots more procedure stations here