Iv injection- intravenous injection

This presentation is about Iv injection which is used by all health professionals to the patients. This presentation includes definition, purpose, types, equipment with procedure and role of nurse all are included.. this is very helpful demonstration for health care settings.

1. INTRAVENOUS INJECTION BY, PREETI SHARMA M.Sc. NURSING 1 ST YR.

2. INTRODUCTION Intravenous therapy (IV) is a therapy that delivers liquid substances directly into a vein (intra- + ven - + - ous ). The intravenous route of administration can be used for injections (with a syringe at higher pressures) or infusions (typically using only the pressure supplied by gravity). Intravenous infusions are commonly referred to as drips. The intravenous route is the fastest way to deliver medications and fluid replacement throughout the body.

3. DEFINITION Intravenous injection is the introduction of the small quantity of the drug into the vein by venous puncture. Introduction of the medicine directly into the blood stream is called intravenous injection.

4. PURPOSE To have fast action of the drug as in emergency. To give medications that are irritating or ineffective when given by other routes. To have the actions of medicines on the blood stream or the blood vessels.

5. COMMON SITES OF IV INJECTION Ventral aspect of elbow or forearm median cubical, basilica or cephalic veins. Dorsal aspect of hand – brachial, cephalic or metacarpal veins. In the infants the scalp vein is used.

6. GENERAL INSTRUCTIONS Expel the air from the syringe before giving the injection by upholding it in upright position and gently pressing the piston until a drop of solution comes to the tip of the needle. Always dissolve the drug in correct amount of fluid to minimize the risk of adverse effect of the medicine. Observe the patient closely for the signs of adverse reaction of the medicine and have emergency drugs and the antidote in hand while injecting the medicine.

7. Cont.. Do not give the medicine if the injection site shows any edema or iv solution is not following properly to avoid accidental administration of medicine into the surrounding tissues. When giving iron preparation always confirms that the patient is not sensitive to it by giving a test dose.

8. TYPE OF IV ADMINISTRATION Adding the medicine in iv solution bottle (intravenous infusion) Existing iv line for continuous infusion. Bolus-direct iv push for immediate or fast action. SELECTION OF SYRINGE AND NEEDLE The size of syringe used for iv infusion depends upon the amount of fluids to be injected. Size of the needle used are 18 to 21 gauge or 1 to 2 inches.

9. PRELIMINARY ASSESSMENT CHECK The diagnosis and age of the patient. The purpose of injection. The doctors order for the type, dosage, time and route of administration. The patient’s name and bed number. The nurses record to find out the time at which the last dose was given. The symptoms of over dose or allergic reaction. The form of the medicine available and correct method of administration.

10. EQUIPMENT A TRAY CONTAINING: Syringe and needles of various sizes according to the need in a covered tray (sterile). Transfer forceps in a jar containing antiseptic solution. Sterile cotton swabs and gauze pieces in sterile containers. Methylated spirit in a container. Bowl with water Tourniquet

11. Cont.. Water for injection. Drug order sheet. File to cut open the ampoules. Small covered tray (sterile).

12. PREPARATION OF THE PATIENT AND ENVIRONMENT Identify the patient correctly Explain the procedure to the patient Provide privacy Place the patient in comfortable and relaxed position suitable of iv injection. Select a site suitable for the route of administration, quantity of medication to be given, and characteristics of medication.

13. PROCEDURE   Read the doctors order and select the medication   Wash hands   Select appropriate syringe and needle and check whether they are in good working order Recheck the order, medicine card with the label of the medicine, expiry date, etc   Mix well and take out the required amount of solution in the syringe   Apply a tourniquet on the upper arm

14. Cont.. Ask the patient to clench and unclench the hand   Pull the skin taut and place the needle in line with vein at a 15 to 45 degree angle  Insert the needle a bit below the point where the needle will pierce the vein.  When the back flow of blood occurs into the syringe release the tourniquet and inject the medicine very slowly Pressure with swab at the puncture site after the needle is withdrawn.

15. AFTER CARE Provide the patient comfortable position Observe the area for bleeding if bleeding occurs apply pressure but do not massage Wash hands Replace all the articles and dispose off the disposable articles Ask the patient to take rest at least 15 to 30 minutes so that you can observe him for any reaction Observe the patient for any allergic reaction Do proper recording and reporting maintain medication chart  

16. ADVANTAGES OF IV INJECTION The therapeutic effect of the drug is seen as soon as it is administered to the patient. IV medication also increases the chances of removal of toxins from the body cells, accelerating the healing process It also prevents the growth and spread of cancerous cells. Chemotherapy is given through IV route so that the drug can move about the body and destroy the harmful cancerous cell.

17. DISADVANTAGES OF IV INJECTION Very slim chances of drug recall, when the drug given to patient shows adverse effect As the drug moves towards the target area quicker than the other methods the concentration of the red blood cells present in the area can get dilated leading to anemia. IV medications sometimes causes precipitate formation that causes embolism myocardial damage.

18. CONTRAINDICATION FOR IV INJECTION FLIP CHART

19. COMPLICATIONS WITH INTRAVENOUS INJECTIONS Infiltration Hematoma Air embolism Phlebitis and thrombophlebitis Extravascular injection Intra-arterial injection Allergic reaction Sepsis Speed shock

20. SCIENTIFIC PRINCIPLES ANATOMY & PHYSIOLOGY Veins are the blood vessels which carry the blood from peripheral tissues towards heart. Skin is a soft flexible, membranous covering & is continuous at the natural orifices with the mucus membrane. MICROBIOLOGY The nurse must wash her hands before & after procedure to prevent cross infections.

21. Cont… All equipment used for the care should be clean to prevent cross infection. PHYSICS & CHEMISTRY Spirit is used to disinfect the skin and it is also a cleansing agent. Antiseptic solution used to disinfectant. PSYCHOLOGY Relieve the anxiety of the patient by explaining what the procedure is, what she is going to do. Provide privacy by screening.

22. NURSING RESPONSIBILITY To verify meds and dosage against the patient's chart and ascertain if the prescribed injection will be harmful or the prescription is misstated, and to make certain the med prescribed is viable for injection site To make sure the injection site is sterile. To ascertain if the injection site is viable To make sure the volume of the injection is compatible with the site of injection.

23. Cont.. To maintain sterile field and bandage properly post injection To monitor patient's reaction post injection to RO anaphylactic or synergistic drug reaction. To do proper reporting and recording

24. CONCLUSION Medications given by IV are usually administered intermittently to treat emergent concerns. Medications administered by direct IV route are given very slowly over Atleast 1 minute. Administering a medication intravenously eliminates the process of drug absorption and breakdown by directly depositing it into the blood. This results in the immediate elevation of serum levels and high concentration in vital organs, such as the heart, brain, and kidneys. Both therapeutic and adverse effects can occur quickly with direct intravenous administration.