INTRAVENOUS IV Therapy

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INTRAVENOUS (IV) Therapy

• SSgt. Mark Thomas
• NREMT-P

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OVERVIEW

• Definition
• Indications
• Equipment and Supplies
• Steps
• Monitoring
• Complications

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Definitions

• Intravenous Fluid Therapy
• Venipuncture
• Keep Vein Open (KVO/TKO)
• Transfusion
• Infusion
• Electrolyte Solution

Medical Terms
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Indicators for IV Therapy

• Shock
• Administration of medications
• Dehydration or replacement of fluid and
  electrolytes

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EQUIPMENT /SUPPLIES

• Administration set (tubing)
• Needle/ catheter
• IV fluids
• Additional supplies

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Administration Sets

• Macro-drip Set - used in emergency situations
  to deliver large amounts of fluid.
• 
  
• Mini-drip Set - used to keep an IV line open,
  flowing with minimal volume infusion.

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Needle / Catheter

• Three types
• Butterfly
• Catheter over needle
• Catheter through needle

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Needle/Catheter

• Sizes
• Large gauge
• 14, 16, 18
• Small gauge
• 20, 21, 22, 23, 26 etc..

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Intravenous Fluids

• Solutions
• 5 Dextrose
• 10 Dextrose
• Normal Saline
• Half-Normal Saline
• Quarter-Normal Saline
• Lactated Ringers

• Abbreviations
• D5W
• D10W
• NS
• 1/2 NS
• 1/4 NS
• LR

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Additional Supplies

• Constricting Band
• Tape
• Scissors
• Gauze
• Cravats
• Short Arm Board
• IV Pole

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Procedure to Start IV Infusion

• Prepare Solution
• Select sight
• Prepare sight
• Perform venipuncture
• Secure

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Prepare Solution

• Fluid selection
• Check solution
• Expiration date
• Sterile seals intact
• Solution is clear
• Administration set
• IV. needle or catheter

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Selecting the Site

• Upper extremity
• Cephalic
• Medial Basilica
• Dorsal Arch (hand)
• Vein is straight
• Not distal to injury sight

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Preparing the Site

• Constricting Band
• 2 - 6 inches above veinpuncture sight
• Restrict venous blood flow only
• Clean Area
• Allergies?
• Betadine pad
• Alcohol pad

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Performing the Venipuncture

• BSI
• Traction
• Insert needle/catheter
• Bevel up
• 30 degree angle
• Advance needle/catheter slowly
• Flash
• Advance 1/4 inch

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Performing the Venipuncture

• Withdraw needle 1/4 inch
• Advance catheter
• Blood samples
• Attach administration set/tubing
• Release constricting band
• Open flow

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Securing IV

• Tape
• 1/2 wide sticky side up under hub
• Criss-cross tape over hub
• Loop tubing and tape
• Transparent IV dressing (Opsight)
• Place over catheter and pucture sight
• Secure to skin
• Loop tubing and tape

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Monitoring the Patient and IV

• Vital signs
• Overhydration
• Monitor flow rate
• Infiltration
• Replacing container

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Complications of IV Therapy

• Local Complications
• Pain
• Infiltration
• Infection
• Arterial puncture

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Complications

• Systemic
• Air embolism
• Circulatory overload
• Anaphylaxis
• Environmental
• Cold climates
• Disposition of needle

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Summary

• Define IV therapy
• Indications
• Equipment and supplies
• Steps
• Monitoring the patient and IV
• Complications

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Questions?