Home intravenous (IV) therapy allows individuals to receive necessary fluids or medications outside of a hospital setting. This process must always be performed under the direct instruction and supervision of a licensed healthcare provider, such as a doctor or a home health nurse.
Preparing the Supplies and Environment
Gather all necessary equipment, including the prescribed IV solution bag, the sterile administration set (tubing), antiseptic wipes, and a dedicated sharps disposal container. A sturdy IV pole or a reliable overhead hook is also required to suspend the bag securely during the infusion.
Thoroughly wash hands with soap and water for at least 20 seconds, paying close attention to the areas under the nails and between the fingers. Dry hands completely with a clean, disposable towel to prevent the transfer of moisture and microorganisms to the sterile equipment.
The workspace, often a clean table or counter, should be disinfected using an approved germicidal wipe or a bleach solution and allowed to air dry.
Choose a quiet, well-lit area free from drafts, pets, and excessive foot traffic to set up the clean field. This dedicated area helps minimize the risk of airborne contamination and infection.
Assembling and Priming the IV Line
Close the roller clamp on the administration set tubing completely to prevent fluid from running freely before priming. Remove the protective cap from the IV bag’s medication port, taking care not to touch the exposed sterile surface.
Next, remove the protective cover from the administration set’s spike, holding the spike only by its protective sheath or collar. Insert the spike firmly into the IV bag’s open port using a straight, twisting motion until the spike is fully seated within the bag’s neck.
This action, known as “spiking the bag,” establishes a closed connection between the fluid source and the delivery tubing. Avoid excessive force, which could damage the system’s integrity.
Immediately after spiking, hold the bag upright and gently squeeze the drip chamber until it is filled about halfway, or to the level indicated by the manufacturer. Filling the chamber partially creates a fluid barrier that helps maintain a constant drip rate and prevents air from entering the system. An overfilled chamber makes it difficult to visually monitor the drops per minute later on.
The process of removing air from the tubing, or “priming,” must be performed carefully to prevent air embolism. Hold the end of the tubing, known as the Luer lock connector, over a waste receptacle, keeping the IV bag elevated above the level of the tubing. Slowly open the roller clamp, allowing the IV solution to begin flowing through the tubing.
Allow the fluid to flow uninterrupted through the entire length of the administration set, carefully inspecting the tubing for any small air bubbles that may be trapped within the line. Continue the flow until the fluid is visible exiting the Luer lock connector, confirming that all air has been completely flushed out. Once the line is fully primed and bubble-free, immediately close the roller clamp to stop the fluid flow and keep the distal end sterile.
Hanging the Bag and Starting the Drip
Once the line is fully primed, suspend the IV bag from the pole or hook, ensuring the fluid level is positioned significantly higher than the patient’s venous access site (typically 18 to 24 inches). This height difference uses gravity to generate sufficient pressure for a consistent flow rate.
Clean the patient’s venous access device connector (such as a needleless port) using an antiseptic wipe following the manufacturer’s prescribed scrub time. Allow the port to air dry completely before connecting to avoid introducing alcohol or contaminating the sterile interface. Maintaining sterility prevents bloodstream infections.
With the access port clean and dry, remove the protective cap from the primed Luer lock connector at the end of the tubing and securely attach it to the patient’s access port using a twist-on motion. Once the connection is secure, slowly open the roller clamp on the administration set to allow the IV fluid to begin flowing into the patient’s line. Observe the drip chamber to confirm the fluid is moving.
Adjust the roller clamp until the drops per minute (gtts/min) visible in the drip chamber precisely match the rate prescribed by the healthcare provider. This flow rate is calculated based on the total volume, infusion time, and the administration set’s drop factor. Counting the drops over a measured time period, such as 15 seconds, and multiplying by four provides an accurate check of the infusion speed.
Monitoring the Infusion and Safe Disposal
Throughout the infusion, routinely check the access site for signs of complication, such as swelling, redness, pain, or coolness, which signal infiltration or infection. Periodically re-check the drip rate in the chamber to ensure it remains consistent with the prescribed flow rate. A sudden change in flow or the appearance of site symptoms requires immediate cessation of the infusion and contacting the healthcare provider.
Once the prescribed volume has been infused, close the roller clamp completely and disconnect the administration set from the patient’s access device. Any items considered sharps, such as needles or pre-filled syringes used for flushing, must be placed directly into a rigid, puncture-proof sharps disposal container. This container must be kept out of reach of children and disposed of according to local biomedical waste regulations.
The empty IV bag and the administration set tubing (contaminated but not sharp) can typically be discarded with regular household trash, unless local regulations dictate otherwise. All non-sharps waste should be securely bagged before disposal. Always perform thorough handwashing immediately after cleanup.