| Intravenous (IV) therapy involves the administration of a therapeutic solution directly into a vein.
Several delivery methods are available, the choice of which depends on the purpose of therapy, the solution to be given, the medical diagnosis, the individual's age and medical history, and the condition of the veins.
Intravenous therapy may be administered for short- or long-term purposes. Short-term IV therapy can be given through veins that are smaller and very close to the skin surface (peripheral veins), such as in the hand, arm, leg, or foot. Long-term IV therapy is generally given through larger, deeper veins (central veins). These veins are used for solutions that may cause damage to small veins, when large amounts of fluid are needed, or to deliver high-calorie solutions that provide nutritional support (although some low-calorie nutritional solutions may be given through a peripheral vein IV). A surgically implanted vascular access device may be inserted under the skin when a central catheter is needed long term.
Depending on the components of the solution, it can be administered slowly (by IV infusion) or rapidly (by injection, "push," or "bolus"). IV solutions may be infused by gravity or using mechanized delivery pump and may be given on an intermittent or continuous basis. |
Source: Medical Disability Advisor
| Intravenous (IV) therapy helps maintain or restore the fluid volume and electrolyte balance of the body, infuse medications, transfuse blood or blood components, and administer high-calorie solutions that provide nutritional support (total parenteral nutrition, or TPN). IV therapy is commonly used to maintain fluid volume in individuals who are not allowed to eat or drink before or after medical or surgical procedures or to restore the fluid volume level in individuals who are severely dehydrated (such as through vomiting or other illness). IV therapy is also used to administer certain drugs that cannot be taken by mouth because they will be destroyed by gastric juices, are irritating, or cannot be absorbed by the gastrointestinal tract. Commonly infused medications include those used to fight infection (antibiotics), to dissolve blood clots (thrombolytics), and to prevent blood clots (anticoagulants). Anticancer medications (chemotherapy), heart and blood pressure medications, anticonvulsants, and pain medications can also be administered intravenously. IV therapy also replaces blood (or plasma) lost in an accident or during an operation. Nutritional supplements and electrolyte replacements may be given through infusion to maintain body fluids in individuals who are unable to eat or drink. Some types of catheters can also be used to withdraw blood for laboratory tests. |
Source: Medical Disability Advisor
| Generally, an intravenous (IV) catheter must be placed before beginning IV therapy, although in some situations, medication may be injected directly into a vein using a needle and syringe. A catheter is a thin, hollow, plastic tube that is introduced through the skin into a vein. Several types of catheters are available. The choice depends on location of insertion and the length of time the catheter needs to remain in use.
The technique for placing a catheter into a vein (venipuncture) varies, depending on the vein to be used (peripheral or central) and on the type of catheter. Before placing the catheter, the solution, tubing, and delivery system are prepared. The catheters most commonly used for a peripheral IV have a fine needle inside the catheter, which is necessary for puncturing the skin and vein during placement.
To insert a peripheral catheter, a tourniquet is placed above the insertion site, filling the vein with blood, making it easier to find and enter the vein. The site is cleansed with an antibacterial solution to prevent infection. A local anesthetic may be given just under the skin to ease any discomfort that may occur during insertion of the catheter. The catheter is inserted through the skin and into the vein. After entry, the catheter is gently threaded into the vein and the tourniquet removed. The needle used for introduction is removed, and the IV tubing that is connected to the solution is attached to the catheter, allowing the solution to drip into the vein. The catheter and tubing are securely taped in place.
Placement of a central catheter varies. Some types of central catheters used for long-term outpatient therapy (peripherally inserted central catheter, PICC lines) are placed by a physician or specially trained nurse. Central catheters may be placed in a large vein in the upper chest area (subclavian vein) or in the neck (internal jugular vein). There is some variation in technique, depending on the type of catheter and the vein to be used. Generally, however, the individual is positioned very carefully, with the head and shoulders slightly lower than the body (Trendelenburg's position), so as to fill the veins with blood (dilate) and to avoid introducing an air embolus. The skin is cleansed with a surgical scrub, and small surgical drapes are placed around the site to help prevent infection. A needle and syringe are used to enter the vein. The syringe is then removed from the needle, and a small guidewire is placed through the needle into the vein; afterward the needle is removed leaving, the guidewire in place. The catheter is inserted into the vein over the guidewire, the guidewire is removed, and the IV tubing connected to the solution is attached to the catheter, allowing infusion to begin. A suture is often used to secure the catheter in place. A dressing is placed over the site, and the tubing is taped to the skin. A plain solution is slowly infused until a chest x-ray confirms that the catheter is in the correct position and that there has been no accidental injury to the lungs. After confirmation of placement, the desired solution at the appropriate rate can be administered.
Vascular access devices are placed by a surgeon through a small incision located in the chest area. This type of IV infusion device is usually placed during a surgical procedure using an x-ray machine (fluoroscopy) to guide placement. A small incision is made, and the catheter is inserted into the vein (often the subclavian, jugular, or cephalic vein). A pocket is made in the subcutaneous tissue, through which the catheter is tunneled. The reservoir is then placed in the pocket and attached to the catheter. The reservoir and the catheters must be flushed with an anticoagulant solution to keep them from clotting closed. The incision is sutured closed and a dressing placed. |
Source: Medical Disability Advisor
| In most cases, intravenous (IV) therapy allows administration of fluids, total parental nutrition, blood transfusions, chemotherapy, and medications, successfully and without occurrence of complications. IV therapy can restore or maintain fluid volume status, maintain daily caloric and nutritional requirements, replace red blood cells and other blood components, treat cancer, and deliver medications. |
Source: Medical Disability Advisor
| There may be problems associated with the catheter, such as kinking or other occlusion of the catheter itself, or developing a clot or an infection at the venous insertion site (phlebitis). The catheter may become dislodged from the vein, allowing medication and fluid to infuse into subcutaneous tissue (infiltration or extravasation), or air may be introduced into the vein (air embolism). During insertion of a central catheter, the lung may be nicked, causing air to leak from the lung into the chest cavity (pneumothorax).
Problems associated with the administration of medications include medication or allergic reaction. Heart rhythm abnormalities (cardiac arrhythmias) can occur if electrolyte solutions such as potassium are infused too rapidly. If too much fluid volume is given, an imbalance of components in the blood (electrolytes) or circulatory overload can result. With blood transfusions, a reaction may develop if there are incompatibilities of blood type. Finally, during administration of total parenteral nutrition, blood sugar may rise too high. |
Source: Medical Disability Advisor
| The underlying reason for the intravenous therapy, rather than the therapy itself, will influence any work restrictions or special accommodations. Time off during the work shift may be needed for infusion of medications, and time off may be needed for medical appointments to assess the condition of and care for the catheter. Work restrictions may be needed if the work area might contaminate the IV site and cause infection. Work restrictions may also be needed to prevent dislodging or damaging the IV catheter. |
Source: Medical Disability Advisor
| "The Facts About Intravenous Catheter Lines." The Body. Apr. 1996. Body Health Resources Corporation. 20 May 2005 <http://www.thebody.com/step/catheter.html>. |
Source: Medical Disability Advisor
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