Clinical Skills: IV Medications

  • Wash hands
  • Introduce self
  • Check patient name and date of birth with patient themselves, their wrist name tag, their notes and their prescription chart
  • Ask permission to give IV drug and ask them about allergies, and offer to explain procedure to patient

First check:
  • Check patient has cannula in situ
  • Reposition the arm to adequately expose the cannula
    • Is the cannula in date? (ideally less than 3 days, maximum 5 days if no signs of complications)
    • Is the port site clean and the skin non-erythematous and not swollen?
  • Check the prescription:
    • Drug to be administered
    • Dose
    • Time and date to be given
    • Prescription signed by prescriber
    • That the drug has not already been given
    • Check with the patient and their drug chart if they have any allergies

Collect your equipment:
  • Clean an equipment tray with alcohol wipe (inside first, then outside), then add:
    • Drug ampoule
    • Drug information sheet
    • Sterile 'Water for Injection'
    • Saline for flushing
    • 2 needles (green)
    • 2 syringes
    • Alcohol swabs
    • 2 pairs of gloves
    • Check the drug, saline, and water are in date with another staff member
  • Don gloves
  • Prepare the drug according to the information leaflet and according to the dose specified on the prescription chart
    • First check the name, dose, administration route and expiry date of drug and check how quickly the drug should be given. Then check the name, administration dose and expiry date of appropriate dilutent.
    • Using a needle and syringe, draw out the required amount of diluent (e.g. 10mL of water for injection), and then insert this into the drug ampoule (once the rubber top has been cleaned with a alcohol wipe). Inject as much water as possible, and shake. Fill the syringe with this mixture. Set this aside on your tray. Use the drug information leaflet to work out how much of this mixture you will actually need to inject.
    • Then using a separate needle and syringe, draw up saline 10mL, then dispose of sharps. Also put this on your tray.

Administer medication
  • Return to the patient and recheck name with patient, label and drug chart
  • Remove gloves, wash hands and don a new pair of gloves
  • Clean cannula port site
  • Warn patient you are going to insert the drug before you do
  • Inject 5mL of saline flush first
    • Specifically checking that no resistance is met, no pain is felt, no swelling is evident and there is no leakage
  • The inject 1mL drug, wait 1 minute to ensure no signs of anaphylaxis, inject rest of drug
    • N.B.: if signs of anaphylaxis do occur, withdraw drug back into needle and assess the patient in a 'DR ABCE' manner
  • If no signs of complications, inject other 5mL saline flush
  • Thank patient and check they are well
  • Explain that if they feel dizzy or short of breath to contact a member of staff and warn them of any side effects from the drug itself (should be on the package leaflet)
  • Sign and date the drug chart.
  • Dispose of equipment and wash hands

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written by: celine_lakra,
first posted on: 1/03/12, 17:00


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