Managing IV lines involves a multi-step process focused on patient safety and effective fluid/medication delivery. This includes regular assessment, proper administration techniques, and timely maintenance.
Essential Steps in IV Line Management
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Initial Assessment and Site Selection: Before inserting an IV line, a thorough assessment of the patient's veins is crucial. Factors such as vein condition, location, and size are considered to select the optimal site, minimizing complications.
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Insertion and Securement: Sterile technique is paramount during insertion. Post-insertion, the IV line is secured with appropriate dressings to prevent dislodgement and infection. The insertion site should be regularly inspected for signs of infiltration, phlebitis, or infection (per reference 1).
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Fluid and Medication Administration: Once the IV line is secure, fluids and medications are administered following precise protocols. This includes accurate calculations of flow rates (reference 3) and adherence to prescribed dosages. Proper use of primary and secondary IV fluid administration sets is necessary (reference 2). Different types of tubing exist; macro-drip and micro-drip are common (reference from https://www.ncbi.nlm.nih.gov/books/NBK593209/).
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Tubing and Dressing Changes: Regular changes of IV tubing (reference 4) and dressings (reference 5) are essential to prevent infection and maintain sterility. The frequency of these changes depends on institutional protocols and the patient's condition. Needleless systems should be used when accessing IV tubing (reference from https://www.cdc.gov/infection-control/hcp/intravascular-catheter-related-infections/summary-recommendations.html).
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Regular Monitoring and Assessment: Continuous monitoring of the IV site for complications like infiltration, inflammation, or infection is vital. Regular patient assessments, including checking the IV site and assessing for adverse reactions, are critical for safe IV management (reference from https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/peripheral_intravenous_iv_device_management/). In cases of suspected reactions, appropriate management procedures should be followed (reference from https://www.lifeblood.com.au/health-professionals/clinical-practice/adverse-events/management-of-suspected-reactions).
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Discontinuation: When the IV therapy is complete, the line must be carefully removed (reference 6). The site is then monitored for bleeding or other complications.
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Fluid Management: Monitoring fluid intake and output is an important aspect of IV therapy management. Tools like the Crit-Line IV Monitor can aid in this process (reference from https://fmcna.com/products/fluid-management/crit-line-iv-monitor/). Managing fluid shortages requires careful planning and conservation strategies (reference from https://www.ashp.org/Drug-Shortages/Shortage-Resources/Publications/fluid-shortages-suggestions-for-management-and-conservation).
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Infection Control: Strict adherence to infection control guidelines is non-negotiable. This involves proper hand hygiene, using sterile equipment, and appropriate disposal of used materials.
Types of IV Lines: Various IV lines exist depending on the duration and purpose of the therapy. Peripheral intravenous catheters (PIVCs) are commonly used for short-term treatment. Longer-term options include PICCs (Peripherally Inserted Central Catheters) and ports (references from https://www.cff.org/managing-cf/vascular-access-devices-piccs-and-ports and https://www.cancer.org/cancer/managing-cancer/making-treatment-decisions/tubes-lines-ports-catheters.html). Patient-controlled analgesia (PCA) pumps are sometimes used to deliver pain medication via an IV line (reference from https://www.hopkinsmedicine.org/health/wellness-and-prevention/palliative-care-methods-for-controlling-pain).
