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PIEDMONT ACCESS TO HEALTH SERVICES, INC. Policy Number: 01-10-031 SUBJECT: Intravenous Infusion EFFECTIVE DATE: 3/2010 REVIEW/REVISE: 7/21/2011 ________________________________________________________________________ Purpose: To maintain or replace body stores of water, electrolytes, vitamins, proteins, calories in the patient who cannot maintain an adequate intake by mouth. To restore acid-base balance. To provide avenues for administration of medications. To keep a vein open in case of emergency. Equipment: 1. 2. 3. 4. 5. 6. Arm board, if needed Butterfly needle, or plastic indwelling catheter (select range depending on patient, or provider’s orders) IV Tubing: a. Standard IV Set (20 gtts/cc) b. Buretrol IV set (60 gtts/cc) Solution as ordered IV Pole Tape Procedure: A. Prepare Equipment: 1. Check physician’s order 2. Prepare the infusion set-up a. Select correct bag of IV solution. Check label on container with provider’s order. b. Remove outer wrap from the bag by tearing straight down along side of container. Check fluid, if not clear or precipitates are present, DO NOT USE. c. Remove blue covering from administration port of container. d. Prepare IV tubing: 2. Buretrol a. Open slide clamp on airway, close upper flo-trol clamp. Close lower flo-trol clamp after sliding it directly under the drip chamber. Remove protector from connector. Using aseptic technique, insert connector into outlet of solution container, using a twisting motion. Suspend container. b. Open upper flo-trol clamp and fill burette chamber with approximately 35 cc of solution; close chamber. c. Open lower flo-trol, squeeze drip chamber and while maintaining squeeze, close lower flo-trol clamp. Release drip chamber and it will partially fill. Repeat until drip chamber is one half filled. 01-10-031 Intravenous Infusion Page 1 of 3 d. Clear tubing with intravenous solution by opening both flo-trol clamps. Close flo-trol clamps when completed. e. Attach patient label to bag, mark type of solution, any medication added, and time infusion started. B. Prepare Patient 1. Explain procedure to patient 2. Provide privacy 3. Verify identity 4. Assist to position of comfort C. Method 1. Insert tubing in IV bag 2. Hang IV bag 3. Apply tourniquet 2-3” above selected IV site to distend vein. a. Other methods to distend vein: 1. Have patient open and close fist 2. Lower hand or arm below bed level 3. Milk veins down toward hand 4. Apply warm cloth to arm 4. Prepare site a. Using alcohol sponge, wipe site in a circular motion from center outward for a period of 30 seconds. 5. Remove needle from package and inspect 6. Stabilize vein 7. Insert IV (refer to Intravenous insertion) D. Document the following in eClinical: 1. Time 2. Type and amount of fluid 3. Rate of flow 4. Medication added, if any 5. Time started and discontinued, amount absorbed 6. Type, size needle and location 7. Any pertinent observation E. Additional Information 1. Whenever a break in technique occurs with an IV system, resulting in part or all, the part involved or all of the system should be changed and new equipment obtained. 2. If after three venipuncture attempts are made you are unsuccessful another qualified person should be called for assistance to continue effort. 3. IV may be started by provider, RN’s and LPN’s who have passed competency. 4. IV site and infusion rate should be checked every 15-30 mm to maintain proper rate of flow. 5. If IV infiltrates, discontinue site and apply warm compresses as needed. F. To Discontinue IV Site 1. Close clamp 2. Loosen tape and dressing. 3. Place alcohol swab over IV site 4. Withdraw needle; apply pressure 01-10-031 Intravenous Infusion Page 2 of 3 5. 6. 7. 8. Check site for bleeding Apply bandaid or polyurethane dressing Make patient comfortable and remove equipment Place all sharps in sharp container SIGNATURES: _______________________________________________ Medical Director ___ / ___ /______ Date _______________________________________________ Director of Clinical Operations ___ / ___ /______ Date 01-10-031 Intravenous Infusion Page 3 of 3