- the right patient;
- with the right medication;
- at the right dose;
- at the right time;
- by the right route;
- and following up with the right documentation.
Sometimes patients must receive medication very rapidly. Other times, medications must be given slowly but constantly. In both of these circumstances, intravenous medication administration may be required. Taking pills or liquids by mouth may not be fast enough to get certain medications into the body. In an emergency setting, medicine must be absorbed quickly. Also, enzymes in the stomach may break down certain delicate medications. As a result, these have to be given directly into the blood stream.
Intravenous is a term that means “into the vein”. Intravenous medication administration occurs when a needle is inserted into a vein and medication is administered through that needle. The needle is usually placed in a vein near the elbow, the wrist, or on the back of the hand. Different sites can be used if necessary.
There are two kinds of intravenous (IV) medication administration. An IV “push” is a one time, rapid injection of medication into the bloodstream. An IV infusion is a slow “drip” of medication into the vein over a set period of time, to deliver a constant amount of therapy.
Often, an IV “line” is created to allow easy treatment. This is a cannula or catheter that is placed into a vein to allow medication to be administered often.
Before any IV medications are administered, a health care professional must follow the six “rights” of medication administration. These are:
Sometimes, an IV medication is given as a “push” or “bolus” dose with a syringe directly into the vein. More often, an IV “line” or peripheral venous catheter (PVC) is inserted for quick and safe access over time.
To insert a venous catheter, a needle is inserted into a vein, most often near the wrist. A thin plastic tube called a catheter is then pushed over the needle. The needle is removed, and the tube remains. Other tubes can be connected to this one with a connecting “hub” or “tap” that remains outside the body.
When an IV line is inserted an IV “drip” is usually started. A drip is a constant flow of sterile liquid from a bag hanging above the patient. The liquid is often a saline (salt) solution. Other medications can be added to this saline solution, and infused into the blood slowly over time. Sometimes a pump is attached to the IV line and pumps liquid into the catheter in a very slow, steady fashion.
For patients who are very sick or who are receiving regular IV therapy for chemotherapy or other reasons, a central line or central venous catheter may be inserted into a vein in the neck or chest.
If you feel anything unusual while beginning IV therapy, tell the health professional treating you. Discomfort and other sensations may be normal. However, they may also be a sign of an allergic reaction, toxicity, or a complication of therapy.
Providing medication intravenously can potentially be dangerous. Infection is possible at the injection site. The entire IV medication administration process must be done with sterile equipment and sterile technique. This should be done by trained professionals, due to the risk of infection.
Some IV drugs that are given as infusions over time can accidentally be given too rapidly as a “push”. This may cause toxicity or damage the vein near the site of injection. Phlebitis, or inflammation of the veins, is a risk with intravenous medications.
A vein may be damaged during injection or by the use of an IV catheter line. This is sometimes called “infiltration”, where the medication leaks into surrounding tissue rather than going into the blood stream. This can cause damage at the site of entry.
Another risk is an air embolism. If there is air in the syringe or in the bag attached to the IV drip, and the line runs dry, air bubbles can enter the vein. This can lead to air bubbles travelling to the heart and lungs. This causes severe problems in circulation.
Blood clots can form due to IV therapy, and deep vein thrombosis can be very dangerous. Clots become stuck in important blood vessels and cause tissue damage or death.
Medications administered intravenously act on the body very quickly. Toxicity, side effects, and allergic reactions will therefore happen fast. A patient on IV medication should be under observation at all times.
Intravenous drugs are potentially very dangerous. Only registered nurses, doctors, or other trained professionals should administer IV therapy.