Intravenous (IV) administration delivers fluids, medications, or nutrients directly into the bloodstream through a vein. This method allows for the rapid and controlled introduction of substances into the circulatory system. Setting up this delivery system, which connects the fluid source to the administration line, requires meticulous attention to detail and sterile technique. Precision in this process maintains the integrity of the fluid and the safety of the delivery.
Gathering Necessary Supplies and Preparing the Area
Gathering all required materials ensures a smooth and uninterrupted procedure. The basic items include the prescribed intravenous solution bag and a new IV administration set (the tubing that connects the bag to the patient’s access site). Additional supplies include an IV pole, non-sterile gloves, and antiseptic wipes for maintaining a clean environment.
Preparation begins with thorough hand hygiene, using soap and water or an alcohol-based sanitizer. This reduces the risk of introducing microorganisms to the sterile equipment. A clean, organized work surface is also necessary to prevent accidental contamination of the sterile components before connection.
Spiking the IV Bag
Spiking connects the IV administration set to the fluid bag, initiating the flow path for the solution. First, locate the roller clamp on the tubing and ensure it is fully closed before proceeding. Closing the clamp prevents the IV fluid from running out immediately after the bag is punctured, which would cause contamination and fluid waste.
The spike is the sharp, pointed end of the administration set and must be kept sterile throughout the process. To prepare the fluid bag, remove the protective cap or cover over the designated spike port without touching the exposed opening. Similarly, remove the protective cover from the spike itself, taking care not to touch its surface.
Insert the sterile spike firmly into the bag’s port using a straight push and slight twisting motion. This action creates a secure seal and establishes the connection between the fluid source and the tubing. Maintaining aseptic technique prevents environmental bacteria from entering the fluid and eventually the patient’s bloodstream.
Priming the IV Line
Priming is the process of filling the IV tubing with solution to remove all air before connecting it to the patient. Removing air is crucial because air introduced into a patient’s vein can cause an air embolism. Hang the spiked bag on the IV pole so that gravity assists with fluid flow.
Partially fill the drip chamber, the small reservoir below the spike, by gently squeezing it until it is about one-third to one-half full of solution. This fluid level prevents air bubbles from rushing down the line and allows for observation of the drip rate. Hold the distal end of the tubing over a sink and slowly open the roller clamp to allow the fluid to flow.
Allow the fluid to run through the entire length of the tubing until all air is flushed out and a steady stream of solution emerges from the end. Inspect the entire length of the tubing for any trapped air bubbles, which can often be dislodged by gently tapping the tubing. Once the tubing is filled and free of air, return the roller clamp to the fully closed position to stop the flow and maintain the prime.
Final Checks and Flow Rate Adjustment
After priming the line, a final verification of the entire system is necessary before connecting it to the patient. Inspect all connection points, especially where the spike enters the bag, to ensure there are no leaks or residual air bubbles. Confirming that the drip chamber remains appropriately filled also ensures that the system is ready for administration.
The final step is setting the correct rate of infusion. If administering by gravity, use the roller clamp to adjust the flow until the drops in the drip chamber match the prescribed rate (gtt/min). If using an electronic infusion pump, load the primed tubing into the device. Program the prescribed rate (mL/hr) into the pump, and then open the roller clamp to begin the infusion.