IV THERAPY

Hams Muneer Aljuaid 44110030)19(

Sumaiah Abdullah Almalki 44110059)29(
Manal Khaled Alharthi 44103913)4(
Manar Alsaadi 44110069)33(
Daniah Mansour Alazwari 44110019)14(
Lujain Muneef Almalki 44110002)8(
Layan Wadea Alosaimi 44110104)47(
Nada Adah Alshalawi 43701809)1(

DR: Ahmad Abdullah

Definition

intravenous therapy or iv therapy: is an effective method to giving liquid substances

(fluids, medicine, nutrition, or blood) directly into a vein. Many therapies are administered as
a "bolus" or one-time dose, but they may also be administered as an extended infusion or
drip.

the word intravenous simply means “within a vein” but is most used to refer to iv therapy.
Iv medications and fluids enter the patient’s bloodstream directly through the vein. They act
rapidly within the body to restore fluid volume and deliver medications. Once a medication
enters the vein, there is no way to terminate this action. Therefore, it is important to properly
prepare the iv medication or fluid, correctly calculate the dosage, and administer it safely to
the patient.
Iv therapy is the fastest way to deliver nutrients throughout the body, because it bypasses the
digestive system and goes directly into the organs, resulting in a 90-100% absorption rate (as
opposed to only 20-50% possible orally) (1).

Iv set

An iv set is a disposable, sterile, and single-use system that connects the medication or fluid
container to the patient’s vascular access site. It typically consists of various components
such as iv tubing, drip chambers, filters, injection ports, connectors, flow regulators, and
needles or catheters (2) (3).

1. Iv tubing

Iv tubing forms the primary pathway through which medications and fluids flow from the iv
bag to the patient’s bloodstream. Typically, manufacturers use transparent, flexible materials
to make iv tubings, enabling easy monitoring of fluid levels and air bubble detection. The
length and diameter of the tubing vary depending on the intended application. Moreover,
designers ensure compatibility with different types of connectors and injection ports.

2. Drip chambers

Drip chambers are small, cylindrical chambers located between the iv tubing and the
patient’s access site. Their main function is to allow healthcare providers to visually monitor
the flow rate of fluids and detect any air bubbles before they reach the patient. Drip
chambers are usually made of transparent material, and they may incorporate additional
features like filters or flow regulators.

3. Iv filters

Iv filters are crucial for removing particulate matter, air bubbles, and contaminants from iv
fluids prior to patient administration. They effectively prevent the infusion of harmful
particles, reducing the risk of complications like embolism or infection. Iv filters come in
different types, including particulate filters, bacterial filters, and air elimination filters.

4. Injection ports and y-sites

Injection ports and y-sites are specialized components of an iv set that allow for the
administration of additional medications or fluids without disrupting the primary infusion.
Injection ports are small, self-sealing access points that healthcare professionals can use to
introduce medications or draw blood samples. Y-sites connect two iv lines into a single line,
allowing simultaneous administration of various fluids or medications.

5. Connectors

Connectors are integral parts of an iv set that facilitate the secure attachment of different
components, such as tubing, filters, and injection ports. They ensure a tight seal and prevent
leakage, reducing the risk of contamination and medication errors. Connectors, such as luer
connectors, needle-free connectors, and screw connectors, come in various designs. Each
design offers specific advantages and compatibility with different devices.
 6. flow regulators

Flow regulators are mechanisms that control the rate

of fluid administration, allowing healthcare
providers to precisely adjust the flow according to
the patient’s needs. They help maintain a consistent
and controlled infusion rate, preventing over- or
under-infusion situations. Flow regulators come in
two types: manual and automatic. They might
include extra features such as flow control buttons
or flow rate indicators.

7. needles and catheters

Figure 1. IV Primary and
Needles and catheters are essential components for secondary tubing set up

gaining vascular access and delivering medications

or fluids directly into the patient’s bloodstream. Healthcare professionals use needles for
initial venipuncture. They then advance catheters through the needle into the vein and secure
them in place. These components vary in size and type, meeting specific clinical needs.
Examples include peripheral catheters, central venous catheters, and arterial catheters.

8. Secondary iv tubing

Shorter in length than primary tubing, with no access ports or backcheck valve; when
connected to a primary line via an access port, used to infuse intermittent medications or
fluids. A secondary tubing administration set is used for secondary iv medication.

Advantages and disadvantages of the intravenous therapy:

The intravenous route has a number of advantages as the drug is delivered immediately upon
the completion of a response requirement and since delivery is into a vein, there is a rapid
onset of drug effects. Such immediacy results in rapid acquisition and strong maintenance of
behavior. A related advantage is the delivery of precise quantities of drug.
Use of the intravenous route also permits the experimenter to give non-contingent drug
deliveries without disturbing the subject.
The major disadvantages of the intravenous route are the relatively short durations of time
that a particular subject can be effectively used. In addition, subject mortality and the
invasiveness of the required procedures (i.e. Surgery must be performed to insert the
catheter) are additional disadvantages.
The short duration is an especially serious problem with rats, and greatly limits the types of
studies that can be conducted. In only a few papers have mortality figures been given
(e.g. Bozarth and wise, 1985). However, the impression obtained from reading the literature
is that death is not uncommon in intravenous studies.
Death may result from infections or from overdoses, another disadvantage is that the animal
must be connected by a tether or leash to the experimental chamber.
in spite of these disadvantages, the intravenous route is one of the most important routes in
drug self-administration studies both because of the data that have been obtained and
because humans often use drugs intravenously; with regard to the latter point, it is worth
noting that infection and death by overdose are not uncommon among humans who
intravenously self-inject drugs (4).

Common uses of iv therapy

• Cold and flu relief: iv therapy has vitamins, minerals and anti-inflammatory agent
that help immune system and relieve uncomfortable symptoms.
• Hydration and improved energy levels: iv often contain essential amino acids as
source of energy.
• Blood transfusions
• Pregnancy symptom alleviation: by manage morning sickness that consists of
symptoms as upset stomach or vomiting.
• Athletic performance recovery
• Hangover treatment
• nutrient deficiency treatment: it’s helps people with crohn’s disease, short bowel
syndrome, cystic fibrosis that have trouble maintaining their nutrient levels.
• Free radicals cleaning
 • Pain or migraine and headache relief (5).

Infection prevention and control

Pathogenesis
catheters contaminate by 2 principal pathways:
1. Migration of skin organisms at the insertion site into the cutaneous catheter tract and
along the surface of the catheter with colonization of the catheter tip; this is the most
common route of infection for short-term catheters (7).
2. Direct contamination of the catheter or catheter hub by contact with hands or
contaminated fluids or devices hub is considered to be the initial site of contamination
of the internal surface pathway (8).

Recommendations for infection prevention

Education, training and staffing

1. Educate healthcare personnel regarding the indications for intravascular catheter use,
proper procedures for the insertion and maintenance of intravascular catheters, and
appropriate infection control measures to prevent intravascular catheter-related
infections (9).
2. Periodically assess knowledge of and adherence to guidelines for all personnel
involved in the insertion and maintenance of intravascular catheters (9).
3. Designate only trained personnel who demonstrate competence for the insertion and
maintenance of peripheral and central intravascular catheters (10).

Hand hygiene and aseptic technique

1. Perform hand hygiene procedures, either by washing hands with conventional soap
and water or with alcohol-based hand rubs (abhr). Hand hygiene should be performed
before and after palpating catheter insertion sites as well as before and after inserting,
 replacing, accessing, repairing, or dressing an intravascular catheter. Palpation of the
insertion site should not be performed after the application of antiseptic, unless aseptic
technique is maintained (11).
2. Maintain aseptic technique for the insertion and care of intravascular catheters (12).

3. Wear clean gloves, rather than sterile gloves, for the insertion of peripheral
intravascular catheters, if the access site is not touched after the application of skin
antiseptics (12).
4. Sterile gloves should be worn for the insertion of arterial, central, and midline
catheters
5. Use new sterile gloves before handling the new catheter when guidewire exchanges
are performed.
6. Wear either clean or sterile gloves when changing the dressing on intravascular
catheters.

Skin preparation

1. Prepare clean skin with an antiseptic (70% alcohol, tincture of iodine, an iodophor or
chlorhexidine gluconate) before peripheral venous catheter insertion (13).
2. Prepare clean skin with a >0.5% chlorhexidine preparation with alcohol before central
venous catheter and peripheral arterial catheter insertion and during dressing changes.
If there is a contraindication to chlorhexidine, tincture of iodine, an iodophor, or 70%
alcohol can be used as alternatives (13).
3. Antiseptics should be allowed to dry according to the manufacturer's recommendation
prior to placing the catheter (13).

Catheter site dressing regimens

1. Use either sterile gauze or sterile, transparent, semi-permeable dressing to cover the
catheter site (14).
2. If the patient is diaphoretic or if the site is bleeding or oozing, use a gauze dressing
until this is resolved (14).
 3. Replace catheter site dressing if the dressing becomes damp, loosened, or visibly
soiled
4. Do not use topical antibiotic ointment or creams on insertion sites, because of their
potential to promote fungal infections and antimicrobial resistance (15).

Iv therapy types

Iv push and iv drip are the two basic forms of iv therapy.

The duration of the treatment and the volume of fluids infused are the primary variations.

Treatments with iv push and iv drip enable 90–100% vitamin absorption.

What is an iv drip?

an iv drip is a sort of intravenous therapy in which a plastic catheter is placed into a vein and
gradually fed into the bloodstream.

An iv drip is administered by inserting a tiny plastic tube, or catheter, into a vein with a
needle. The needle is swiftly removed once the plastic tube is advanced into the vein.

Iv drips take 45 to 60 minutes to complete, and each session typically involves the injection
of 250 to 1000 ml of fluid.

Clients can read, work, or unwind during a drip.

What is an iv push?

An iv push is slowly administrated into a vein via a previously inserted plastic catheter.

Iv pushes are performed for 15-20 minutes and a total of 30-60 ml of fluids are slowly
pressed into a vein.

Because of the nature of the process, iv pushes are supervised by specialists at all times.
What is in an iv drip?

The contents of an iv drip will vary depending on the treatment being administered. Seeing
as an iv drip is the quickest way to deliver fluids and medications into the bloodstream they
are usually made up of the following:

• Saline solution: a sterile solution of water and salt that is used to provide hydration
and maintain electrolyte balance in the body.

• Glucose solution: a sterile solution of water and glucose (sugar) that provides energy
to the body.

• Nutrients: iv drips can also contain a variety of nutrients such as vitamins, minerals,
and amino acids that are required for the body to function properly.

When admitted to hospital what is in an iv drip may look a bit different. While it may still
include the fluids mentioned above it can also include:

• Medications: depending on the condition being treated, various medications can

be added to the iv drip to treat pain, nausea, infection, or other medical issues.

• Blood products: in some cases, iv drips may blood to restore factors such as red blood
cells, plasma, or platelets to help with conditions like anemia or bleeding disorders or
if the patient has been injured and lost blood.

• Contrast agents: substances used in medical imaging to enhance the visibility of

certain structures or fluids in the body. Sometimes they are delivered through an iv
drip during imaging procedures like ct scans or mris. (16)

Complication and management of iv therapy

infiltration and extravasation occurs when the infused fluid or medication leaks into the
surrounding tissues instead of entering the vein lead to blisters and necrosis (tissue death),
different between infiltration and extravasation in type of fluid or medication use,

management by stop and remove iv therapy (17) (18).

phlebitis inflammation of a vein in site or near iv catheter therapy, management by stop and
remove iv therapy, elevating the limb (17) (18).

Classified factors cause phebitits:

1. Mechanical
Inappropriate insertion iv catheter therapy, rigid catheter material or larger gauge and
longer length (18).
2. Chemical
Hypertonic solutions >375 mosm/l, medications and solutions ph <5 or >9, irritant or
have large particles (18).

3. Bacterial
 Not use aseptic technique, non-sterile iv system (18).
hematoma localized collection of blood outside the
blood vessels occurs when there is damage to the blood
vessels, controlled by applying cold compresses initially
to reduce swelling, followed by warm compresses to
enhance blood circulation, in severe case surgical remove (18).

air embolism (life-threatening) occurs when air or gas

bubbles enter the bloodstream and block a blood vessel
during insertion or removal iv therapy, management
strategies involve:
1. Stop and remove iv therapy
2. Change positions to left side down head
3. Supportive care and monitoring the vital signs and symptoms (18)

Conclusion:
Intravenous therapy is always one of the most important treatments due to its strength and
rapid effect. As it has absolutely no effect from the first pass. It also has many negatives that
may be fatal.

References:

(1) Charmley,sarah.(March 27,2023).What to know about IV therapy.

https://www.medicalnewstoday.com/articles/iv-therapy

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comprehensive guide - MEDIKART healthcare systems.
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(3) Doyle, G. R., & McCutcheon, J. A. (2015, November 23). 8.3 IV fluids, IV tubing, and
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