Intravenous therapy (abbreviated as IV therapy) is a medical technique that administers fluids, medications and nutrients directly into a person's vein. The intravenous
route of administration
A route of administration in pharmacology and toxicology is the way by which a medication, drug, fluid, poison, or other substance is taken into the body.
Routes of administration are generally classified by the location at which the substance i ...
is commonly used for rehydration or to provide nutrients for those who cannot, or will not—due to reduced mental states or otherwise—consume food or water
by mouth
Oral administration is a route of administration where a substance is taken through the mouth. Per os abbreviated to P.O. is sometimes used as a direction for medication to be taken orally. Many medications are taken orally because they are i ...
. It may also be used to administer
medications
A medication (also called medicament, medicine, pharmaceutical drug, medicinal drug or simply drug) is a drug used to diagnose, cure, treat, or prevent disease. Drug therapy (pharmacotherapy) is an important part of the medical field and rel ...
or other medical therapy such as
blood products
A blood product is any therapeutic substance prepared from human blood. This includes whole blood; blood components; and plasma derivatives. Whole blood is not commonly used in transfusion medicine. Blood components include: red blood cell conce ...
or
electrolyte
An electrolyte is a medium containing ions that is electrically conducting through the movement of those ions, but not conducting electrons. This includes most soluble salts, acids, and bases dissolved in a polar solvent, such as water. Upon dis ...
s to correct
electrolyte imbalance
Electrolyte imbalance, or water-electrolyte imbalance, is an abnormality in the concentration of electrolytes in the body. Electrolytes play a vital role in maintaining homeostasis in the body. They help to regulate heart and neurological function, ...
s. Attempts at providing intravenous therapy have been recorded as early as the 1400s, but the practice did not become widespread until the 1900s after the development of techniques for safe, effective use.
The intravenous route is the fastest way to deliver medications and
fluid replacement
Fluid replacement or fluid resuscitation is the medical practice of replenishing bodily fluid lost through sweating, bleeding, fluid shifts or other pathologic processes. Fluids can be replaced with oral rehydration therapy (drinking), intravenous ...
throughout the body as they are introduced directly into the
circulatory system
The blood circulatory system is a system of organs that includes the heart, blood vessels, and blood which is circulated throughout the entire body of a human or other vertebrate. It includes the cardiovascular system, or vascular system, tha ...
and thus quickly distributed. For this reason, the intravenous route of administration is also used for the consumption of some
recreational drugs
Recreation is an activity of leisure, leisure being discretionary time. The "need to do something for recreation" is an essential element of human biology and psychology. Recreational activities are often done for enjoyment, amusement, or pleasur ...
. Many therapies are administered as a "
bolus" or one-time dose, but they may also be administered as an extended ''infusion'' or ''drip''. The act of administering a therapy intravenously, or placing an intravenous line ("IV line") for later use, is a procedure which should only be performed by a skilled professional. The most basic intravenous access consists of a needle piercing the skin and entering a vein which is connected to a
syringe
A syringe is a simple reciprocating pump consisting of a plunger (though in modern syringes, it is actually a piston) that fits tightly within a cylindrical tube called a barrel. The plunger can be linearly pulled and pushed along the inside ...
or to external tubing. This is used to administer the desired therapy. In cases where a patient is likely to receive many such interventions in a short period (with consequent risk of trauma to the vein), normal practice is to insert a
cannula
A cannula (; Latin meaning 'little reed'; plural or ) is a tube that can be inserted into the body, often for the delivery or removal of fluid or for the gathering of samples. In simple terms, a cannula can surround the inner or outer surfaces ...
which leaves one end in the vein, and subsequent therapies can be administered easily through tubing at the other end. In some cases, multiple medications or therapies are administered through the same IV line.
IV lines are classified as "central lines" if they end in a large vein close to the heart, or as "peripheral lines" if their output is to a small vein in the periphery, such as the arm. An IV line can be threaded through a peripheral vein to end near the heart, which is termed a "peripherally inserted central catheter" or PICC line. If a person is likely to need long-term intravenous therapy, a medical port may be implanted to enable easier repeated access to the vein without having to pierce the vein repeatedly. A catheter can also be inserted into a central vein through the chest, which is known as a tunneled line. The specific type of catheter used and site of insertion are affected by the desired substance to be administered and the health of the veins in the desired site of insertion.
Placement of an IV line may cause pain, as it necessarily involves piercing the skin. Infections and inflammation (termed
phlebitis
Phlebitis (or Venitis) is inflammation of a vein, usually in the legs. It most commonly occurs in superficial veins. Phlebitis often occurs in conjunction with thrombosis and is then called thrombophlebitis or superficial thrombophlebitis. Unlike ...
) are also both common side effects of an IV line. Phlebitis may be more likely if the same vein is used repeatedly for intravenous access, and can eventually develop into a hard cord which is unsuitable for IV access. The unintentional administration of a therapy outside a vein, termed extravasation or infiltration, may cause other side effects.
Uses
Medical uses
Intravenous (IV) access is used to administer medications and fluid replacement which must be distributed throughout the body, especially when rapid distribution is desired. Another use of IV administration is the avoidance of
first-pass metabolism
The first pass effect (also known as first-pass metabolism or presystemic metabolism) is a phenomenon of drug metabolism whereby the concentration of a drug, specifically when administered orally, is greatly reduced before it reaches the systemi ...
in the
liver
The liver is a major Organ (anatomy), organ only found in vertebrates which performs many essential biological functions such as detoxification of the organism, and the Protein biosynthesis, synthesis of proteins and biochemicals necessary for ...
. Substances that may be infused intravenously include
volume expander
A volume expander is a type of intravenous therapy that has the function of providing volume for the circulatory system. It may be used for fluid replacement or during surgery to prevent nausea and vomiting after surgery.
Physiology
When blood is ...
s,
blood-based products,
blood substitutes
A blood substitute (also called artificial blood or blood surrogate) is a substance used to mimic and fulfill some functions of biological blood. It aims to provide an alternative to blood transfusion, which is transferring blood or blood-based ...
, medications and nutrition.
Fluid solutions
Fluids may be administered as part of "volume expansion", or fluid replacement, through the intravenous route. Volume expansion consists of the administration of fluid-based solutions or suspensions designed to target specific areas of the body which need more water. There are two main types of volume expander:
crystalloids
A volume expander is a type of intravenous therapy that has the function of providing volume for the circulatory system. It may be used for fluid replacement or during surgery to prevent nausea and vomiting after surgery.
Physiology
When blood is ...
and
colloid
A colloid is a mixture in which one substance consisting of microscopically dispersed insoluble particles is suspended throughout another substance. Some definitions specify that the particles must be dispersed in a liquid, while others extend ...
s. Crystalloids are
aqueous solution
An aqueous solution is a solution in which the solvent is water. It is mostly shown in chemical equations by appending (aq) to the relevant chemical formula. For example, a solution of table salt, or sodium chloride (NaCl), in water would be re ...
s of mineral salts or other water-soluble molecules. Colloids contain larger insoluble molecules, such as
gelatin
Gelatin or gelatine (from la, gelatus meaning "stiff" or "frozen") is a translucent, colorless, flavorless food ingredient, commonly derived from collagen taken from animal body parts. It is brittle when dry and rubbery when moist. It may also ...
.
Blood
Blood is a body fluid in the circulatory system of humans and other vertebrates that delivers necessary substances such as nutrients and oxygen to the cells, and transports metabolic waste products away from those same cells. Blood in the c ...
itself is considered a colloid.
The most commonly used crystalloid fluid is
normal saline
Saline (also known as saline solution) is a mixture of sodium chloride (salt) and water. It has a number of uses in medicine including cleaning wounds, removal and storage of contact lenses, and help with dry eyes. By injection into a vein it ...
, a solution of
sodium chloride
Sodium chloride , commonly known as salt (although sea salt also contains other chemical salts), is an ionic compound with the chemical formula NaCl, representing a 1:1 ratio of sodium and chloride ions. With molar masses of 22.99 and 35.45 g ...
at 0.9% concentration, which is
isotonic with blood. Lactated Ringer's (also known as ''
Ringer's lactate
Ringer's lactate solution (RL), also known as sodium lactate solution, Lactated Ringer’s, and Hartmann's solution, is a mixture of sodium chloride, sodium lactate, potassium chloride, and calcium chloride in water. It is used for replacing fl ...
'') and the closely related ''Ringer's acetate'', are mildly
hypotonic
In chemical biology, tonicity is a measure of the effective osmotic pressure gradient; the water potential of two solutions separated by a partially-permeable cell membrane. Tonicity depends on the relative concentration of selective membrane-imp ...
solutions often used in those who have significant
burn
A burn is an injury to skin, or other tissues, caused by heat, cold, electricity, chemicals, friction, or ultraviolet radiation (like sunburn). Most burns are due to heat from hot liquids (called scalding), solids, or fire. Burns occur mainl ...
s. Colloids preserve a high
colloid osmotic pressure
Oncotic pressure, or colloid osmotic-pressure, is a form of osmotic pressure induced by the proteins, notably albumin, in a blood vessel's plasma (blood/liquid) that causes a pull on fluid back into the capillary. Participating colloids displace ...
in the blood, while, on the other hand, this parameter is decreased by crystalloids due to hemodilution.
Crystalloids generally are much cheaper than colloids.
[
]Buffer solution
A buffer solution (more precisely, pH buffer or hydrogen ion buffer) is an aqueous solution consisting of a mixture of a weak acid and its conjugate base, or vice versa. Its pH changes very little when a small amount of strong acid or base is ...
s which are used to correct acidosis
Acidosis is a process causing increased acidity in the blood and other body tissues (i.e., an increase in hydrogen ion concentration). If not further qualified, it usually refers to acidity of the blood plasma.
The term ''acidemia'' describes t ...
or alkalosis
Alkalosis is the result of a process reducing hydrogen ion concentration of arterial blood plasma (alkalemia). In contrast to acidemia (serum pH 7.35 or lower), alkalemia occurs when the serum pH is higher than normal (7.45 or higher). Alkalosis ...
are also administered through intravenous access. Lactated Ringer's solution
Ringer's lactate solution (RL), also known as sodium lactate solution, Lactated Ringer’s, and Hartmann's solution, is a mixture of sodium chloride, sodium lactate, potassium chloride, and calcium chloride in water. It is used for replacing ...
used as a fluid expander or base solution to which medications are added also has some buffering effect. Another solution administered intravenously as a buffering solution is sodium bicarbonate
Sodium bicarbonate (IUPAC name: sodium hydrogencarbonate), commonly known as baking soda or bicarbonate of soda, is a chemical compound with the formula NaHCO3. It is a salt composed of a sodium cation ( Na+) and a bicarbonate anion ( HCO3−) ...
.
Medication and treatment
Medication
A medication (also called medicament, medicine, pharmaceutical drug, medicinal drug or simply drug) is a drug used to diagnose, cure, treat, or prevent disease. Drug therapy (pharmacotherapy) is an important part of the medical field and re ...
s may be mixed into the fluids mentioned above, commonly normal saline, or dextrose
Glucose is a simple sugar with the molecular formula . Glucose is overall the most abundant monosaccharide, a subcategory of carbohydrates. Glucose is mainly made by plants and most algae during photosynthesis from water and carbon dioxide, using ...
solutions. Compared with other routes of administration
A route of administration in pharmacology and toxicology is the way by which a medication, drug, fluid, poison, or other substance is taken into the body.
Routes of administration are generally classified by the location at which the substance i ...
, such as oral medications, the IV route is the fastest way to deliver fluids and medications throughout the body. For this reason, the IV route is commonly preferred in emergency situations or when a fast onset of action is desirable. In extremely high blood pressure (termed a hypertensive emergency), IV antihypertensives may be given to quickly decrease the blood pressure in a controlled manner to prevent organ damage. In atrial fibrillation, IV amiodarone
Amiodarone is an antiarrhythmic medication used to treat and prevent a number of types of cardiac dysrhythmias. This includes ventricular tachycardia (VT), ventricular fibrillation (VF), and wide complex tachycardia, as well as atrial fibrilla ...
may be administered to attempt to restore normal heart rhythm. IV medications can also be used for chronic health conditions such as cancer, for which chemotherapy drugs are commonly administered intravenously. In some cases, such as with vancomycin
Vancomycin is a glycopeptide antibiotic medication used to treat a number of bacterial infections. It is recommended intravenously as a treatment for complicated skin infections, bloodstream infections, endocarditis, bone and joint infections, ...
, a loading or bolus dose of medicine is given before beginning a dosing regimen to more quickly increase the concentration of medication in the blood.
The bioavailability
In pharmacology, bioavailability is a subcategory of absorption and is the fraction (%) of an administered drug that reaches the systemic circulation.
By definition, when a medication is administered intravenously, its bioavailability is 100%. H ...
of an IV medication is by definition 100%, unlike oral administration where medication may not be fully absorbed, or may be metabolized prior to entering the bloodstream. For some medications, there is virtually zero oral bioavailability. For this reason certain types of medications can only be given intravenously, as there is insufficient uptake by other routes of administration
A route of administration in pharmacology and toxicology is the way by which a medication, drug, fluid, poison, or other substance is taken into the body.
Routes of administration are generally classified by the location at which the substance i ...
, such is the case of severe dehydration where the patient is required to be treated via IV therapy for a quick recovery. The unpredictability of oral bioavailability in different people is also a reason for a medication to be administered IV, as with furosemide
Furosemide is a loop diuretic medication used to treat fluid build-up due to heart failure, liver scarring, or kidney disease. It may also be used for the treatment of high blood pressure. It can be taken by injection into a vein or by mouth ...
. Oral medications also may be less desirable if a person is nauseous or vomiting, or has severe diarrhea, as these may prevent the medicine from being fully absorbed from the gastrointestinal tract. In these cases, a medication may be given IV only until the patient can tolerate an oral form of the medication. The switch from IV to oral administration is usually performed as soon as viable, as there is generally cost and time savings over IV administration. Whether a medication can be potentially switched to an oral form is sometimes considered when choosing appropriate antibiotic therapy for use in a hospital setting, as a person is unlikely to be discharged if they still require IV therapy.
Some medications, such as aprepitant
Aprepitant, sold under the brand name Emend among others, is a medication used to prevent chemotherapy-induced nausea and vomiting (CINV) and to prevent postoperative nausea and vomiting (PONV). It may be used together with ondansetron and de ...
, are chemically modified to be better suited for IV administration, forming a prodrug
A prodrug is a medication or compound that, after intake, is metabolized (i.e., converted within the body) into a pharmacologically active drug. Instead of administering a drug directly, a corresponding prodrug can be used to improve how the drug ...
such as fosaprepitant
Fosaprepitant (Emend for Injection (US), Ivemend (EU)) is an antiemetic medication
A medication (also called medicament, medicine, pharmaceutical drug, medicinal drug or simply drug) is a drug used to diagnose, cure, treat, or prevent d ...
. This can be for pharmacokinetic reasons or to delay the effect of the drug until it can be metabolized into the active form.
Blood products
A blood product
A blood product is any therapeutic substance prepared from human blood. This includes whole blood; blood components; and plasma derivatives. Whole blood is not commonly used in transfusion medicine. Blood components include: red blood cell concen ...
(or ''blood-based product'') is any component of blood
Blood is a body fluid in the circulatory system of humans and other vertebrates that delivers necessary substances such as nutrients and oxygen to the cells, and transports metabolic waste products away from those same cells. Blood in the c ...
which is collected from a donor for use in a blood transfusion
Blood transfusion is the process of transferring blood products into a person's circulation intravenously. Transfusions are used for various medical conditions to replace lost components of the blood. Early transfusions used whole blood, but mo ...
. Blood transfusions can be used in massive blood loss due to trauma
Trauma most often refers to:
* Major trauma, in physical medicine, severe physical injury caused by an external source
* Psychological trauma, a type of damage to the psyche that occurs as a result of a severely distressing event
*Traumatic i ...
, or can be used to replace blood lost during surgery
Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pat ...
. Blood transfusions may also be used to treat a severe anaemia
Anemia or anaemia (British English) is a blood disorder in which the blood has a reduced ability to carry oxygen due to a lower than normal number of red blood cells, or a reduction in the amount of hemoglobin. When anemia comes on slowly, th ...
or thrombocytopenia
Thrombocytopenia is a condition characterized by abnormally low levels of platelets, also known as thrombocytes, in the blood. It is the most common coagulation disorder among intensive care patients and is seen in a fifth of medical patients an ...
caused by a blood disease. Early blood transfusions consisted of whole blood
Whole blood (WB) is human blood from a standard blood donation. It is used in the treatment of massive bleeding, in exchange transfusion, and when people donate blood to themselves. One unit of whole blood (~517 mls) brings up hemoglobin lev ...
, but modern medical practice commonly uses only components of the blood, such as packed red blood cells
Packed red blood cells, also known as packed cells, are red blood cells that have been separated for blood transfusion. The packed cells are typically used in anemia that is either causing symptoms or when the hemoglobin is less than usually 70 ...
, fresh frozen plasma
Fresh frozen plasma (FFP) is a blood product made from the liquid portion of whole blood. It is used to treat conditions in which there are low blood clotting factors (INR > 1.5) or low levels of other blood proteins. It may also be used as the re ...
or cryoprecipitate
Cryoprecipitate, also called cryo for short, is a frozen blood product prepared from blood plasma. To create cryoprecipitate, fresh frozen plasma thawed to 1–6 °C is then centrifuged and the precipitate is collected. The precipitate is r ...
.
Nutrition
Parenteral nutrition
Parenteral nutrition (PN) is the feeding of nutritional products to a person intravenously, bypassing the usual process of eating and digestion. The products are made by pharmaceutical compounding companies. The person receives a nutritional mix ...
is the act of providing required nutrients to a person through an intravenous line. This is used in people who are unable to get nutrients normally, by eating
Eating (also known as consuming) is the ingestion of food, typically to provide a heterotrophic organism with energy and to allow for growth. Animals and other heterotrophs must eat in order to survive — carnivores eat other animals, herbi ...
and digesting
Digestion is the breakdown of large insoluble food molecules into small water-soluble food molecules so that they can be absorbed into the watery blood plasma. In certain organisms, these smaller substances are absorbed through the small intest ...
food. A person receiving parenteral nutrition will be given an intravenous solution which may contain salt
Salt is a mineral composed primarily of sodium chloride (NaCl), a chemical compound belonging to the larger class of salts; salt in the form of a natural crystalline mineral is known as rock salt or halite. Salt is present in vast quantitie ...
s, dextrose
Glucose is a simple sugar with the molecular formula . Glucose is overall the most abundant monosaccharide, a subcategory of carbohydrates. Glucose is mainly made by plants and most algae during photosynthesis from water and carbon dioxide, using ...
, amino acid
Amino acids are organic compounds that contain both amino and carboxylic acid functional groups. Although hundreds of amino acids exist in nature, by far the most important are the alpha-amino acids, which comprise proteins. Only 22 alpha am ...
s, lipid
Lipids are a broad group of naturally-occurring molecules which includes fats, waxes, sterols, fat-soluble vitamins (such as vitamins A, D, E and K), monoglycerides, diglycerides, phospholipids, and others. The functions of lipids include ...
s and vitamin
A vitamin is an organic molecule (or a set of molecules closely related chemically, i.e. vitamers) that is an Nutrient#Essential nutrients, essential micronutrient that an organism needs in small quantities for the proper functioning of its ...
s. The exact formulation of a parenteral nutrition used will depend on the specific nutritional needs of the person it is being given to. If a person is only receiving nutrition intravenously, it is called total parenteral nutrition (TPN), whereas if a person is only receiving some of their nutrition intravenously it is called partial parenteral nutrition (or supplemental parenteral nutrition).
Imaging
Medical imaging relies on being able to clearly distinguish internal parts of the body from each other. One way this is accomplished is through the administration of a contrast agent
A contrast agent (or contrast medium) is a substance used to increase the contrast of structures or fluids within the body in medical imaging. Contrast agents absorb or alter external electromagnetism or ultrasound, which is different from radiop ...
into a vein. The specific imaging technique being employed will determine the characteristics of an appropriate contrast agent to increase visibility of blood vessels or other features. Common contrast agents are administered into a peripheral vein from which they are distributed throughout the circulation to the imaging site.
Other uses
Use in sports
IV rehydration was formerly a common technique for athletes. The World Anti-Doping Agency
The World Anti-Doping Agency (WADA; french: Agence mondiale antidopage, AMA) is a foundation initiated by the International Olympic Committee based in Canada to promote, coordinate, and monitor the fight against drugs in sports. The agency's key ...
prohibits intravenous injection of more than 100mL per 12 hours, except under a medical exemption. The United States Anti-Doping Agency
The United States Anti-Doping Agency (USADA, ) is a non-profit, non-governmental 501(c)(3) organization and the national anti- doping organization (NADO) for the United States. To protect clean competition and the integrity of sport and prevent ...
notes that, as well as the dangers inherent in IV therapy, "IVs can be used to change blood test
A blood test is a laboratory analysis performed on a blood sample that is usually extracted from a vein in the arm using a hypodermic needle, or via fingerprick. Multiple tests for specific blood components, such as a glucose test or a cholester ...
results (such as hematocrit
The hematocrit () (Ht or HCT), also known by several other names, is the volume percentage (vol%) of red blood cells (RBCs) in blood, measured as part of a blood test. The measurement depends on the number and size of red blood cells. It is norm ...
where EPO or blood doping
Blood doping is a form of doping in which the number of red blood cells in the bloodstream is boosted in order to enhance athletic performance. Because such blood cells carry oxygen from the lungs to the muscles, a higher concentration in the bl ...
is being used), mask urine test
A urine test is any medical test performed on a urine specimen. The analysis of urine is a valuable diagnostic tool because its composition reflects the functioning of many body systems, particularly the kidneys and urinary system, and specimens a ...
results (by dilution) or by administering prohibited substances in a way that will more quickly be cleared from the body in order to beat an anti-doping test". Players suspended after attending "boutique IV clinics" which offer this sort of treatment include footballer Samir Nasri
Samir Nasri (born 26 June 1987) is a French former professional footballer. He primarily played as an attacking midfielder and a winger, although he had also been deployed in central midfield.
Nasri was known for his dribbling, ball control ...
in 2017 and swimmer Ryan Lochte
Ryan Steven Lochte ( ; born August 3, 1984) is an American professional swimmer and 12-time Olympic medalist. Along with Natalie Coughlin, Dara Torres, and Jenny Thompson, he is the second-most decorated swimmer in Olympic history measured by to ...
in 2018.
Use for hangover treatment
In the 1960s, John Myers developed the "Myers' cocktail
Myers' cocktail is an intravenous (IV) vitamin therapy that lacks scientific evidence to support its use as a medical treatment. The term, Myers' cocktail, is included in Quackwatch's index of questionable treatments.
The name is attributed to ...
", a non-prescription IV solution of vitamins and minerals marketed as a hangover cure
Hangover remedies consist of foods, dishes, and medicines, that have been described as having a theoretical potential for easing or alleviating symptoms associated with the hangover.
List of hangover foods
Scientific
* Asparagus: In a small ce ...
and general wellness remedy. The first "boutique IV" clinic, offering similar treatments, opened in Tokyo in 2008. These clinics, whose target market was described by ''Elle
''Elle'' (stylized ''ELLE'') is a worldwide women's magazine of French origin that offers a mix of fashion and beauty content, together with culture, society and lifestyle. The title means "she" or "her" in French. ''Elle'' is considered the w ...
'' as "health nuts who moonlight as heavy drinkers", have been publicized in the 2010s by glamorous celebrity customers. Intravenous therapy is also used in people with acute ethanol toxicity to correct electrolyte and vitamin deficiencies which arise from alcohol consumption.
Others
In some countries, non-prescription intravenous glucose is used to improve a person's energy, but is not a part of routine medical care in countries such as the United States where glucose solutions are prescription drugs. Improperly administered intravenous glucose (called "ringer"), such as that which is administered clandestinely in store-front clinics, poses increased risks due to improper technique and oversight. Intravenous access is also sometimes used outside of a medical setting for the self-administration of recreational drugs, such as heroin
Heroin, also known as diacetylmorphine and diamorphine among other names, is a potent opioid mainly used as a recreational drug for its euphoric effects. Medical grade diamorphine is used as a pure hydrochloride salt. Various white and brow ...
and fentanyl
Fentanyl, also spelled fentanil, is a very potent synthetic opioid used as a pain medication. Together with other drugs, fentanyl is used for anesthesia. It is also used illicitly as a recreational drug, sometimes mixed with heroin, cocaine ...
, cocaine, methamphetamine, DMT, and others.
Types
Bolus
Some medications can be administered as a bolus dose, which is called an "IV push". A syringe containing the medication is connected to an access port in the primary tubing and the medication is administered through the port. A bolus may be administered rapidly (with a fast depression of the syringe plunger) or may be administered slowly, over the course of a few minutes. The exact administration technique depends on the medication and other factors. In some cases, a bolus of plain IV solution (i.e. without medication added) is administered immediately after the bolus to further force the medicine into the bloodstream. This procedure is termed an "IV flush". Certain medications, such as potassium, are not able to be administered by IV push due to the extremely rapid onset of action and high level of effects.
Infusion
An infusion of medication may be used when it is desirable to have a constant blood concentration of a medication over time, such as with some antibiotics including beta-lactams. Continuous infusions, where the next infusion is begun immediately following the completion of the prior, may also be used to limit variation in drug concentration in the blood (i.e. between the peak drug levels and the trough drug levels). They may also be used instead of intermittent bolus injections for the same reason, such as with furosemide
Furosemide is a loop diuretic medication used to treat fluid build-up due to heart failure, liver scarring, or kidney disease. It may also be used for the treatment of high blood pressure. It can be taken by injection into a vein or by mouth ...
. Infusions can also be intermittent, in which case the medication is administered over a period of time, then stopped, and this is later repeated. Intermittent infusion may be used when there are concerns about the stability of medicine in solution for long periods of time (as is common with continuous infusions), or to enable the administration of medicines which would be incompatible if administered at the same time in the same IV line, for example vancomycin.
Failure to properly calculate and administer an infusion can result in adverse effects, termed infusion reactions. For this reason, many medications have a maximum recommended infusion rate, such as vancomycin
Vancomycin is a glycopeptide antibiotic medication used to treat a number of bacterial infections. It is recommended intravenously as a treatment for complicated skin infections, bloodstream infections, endocarditis, bone and joint infections, ...
and many monoclonal antibodies
A monoclonal antibody (mAb, more rarely called moAb) is an antibody produced from a cell Lineage made by cloning a unique white blood cell. All subsequent antibodies derived this way trace back to a unique parent cell.
Monoclonal antibodies ca ...
. These infusion reactions can be severe, such as in the case of vancomycin, where the reaction is termed "red man syndrome".
Secondary
Any additional medication to be administered intravenously at the same time as an infusion may be connected to the primary tubing; this is termed a secondary IV, or IV piggyback. This prevents the need for multiple IV access lines on the same person. When administering a secondary IV medication, the primary bag is held lower than the secondary bag so that the secondary medication can flow into the primary tubing, rather than fluid from the primary bag flowing into the secondary tubing. The fluid from the primary bag is needed to help flush any remaining medication from the secondary IV from the tubing. If a bolus or secondary infusion is intended for administration in the same line as a primary infusion, the molecular compatibility of the solutions must be considered. Secondary compatibility is generally referred to as "y-site compatibility", named after the shape of the tubing which has a port for bolus administration. Incompatibility of two fluids or medications can arise due to issues of molecular stability, changes in solubility, or degradation of one of the medications.
Methods and equipment
Access
The simplest form of intravenous access is by passing a hollow needle through the skin directly into a vein. A syringe can be connected directly to this needle, which allows for a "bolus" dose to be administered. Alternatively, the needle may be placed and then connected to a length of tubing, allowing for an infusion to be administered. The type and location of venous access (i.e. a central line versus peripheral line, and in which vein the line is placed) can be affected by the potential for some medications to cause peripheral vasoconstriction, which limits circulation to peripheral veins.
A peripheral cannula
A cannula (; Latin meaning 'little reed'; plural or ) is a tube that can be inserted into the body, often for the delivery or removal of fluid or for the gathering of samples. In simple terms, a cannula can surround the inner or outer surfaces ...
is the most common intravenous access method utilized in hospital
A hospital is a health care institution providing patient treatment with specialized health science and auxiliary healthcare staff and medical equipment. The best-known type of hospital is the general hospital, which typically has an emerge ...
s, pre-hospital
Emergency medical services (EMS), also known as ambulance services or paramedic services, are emergency services that provide urgent pre-hospital treatment and stabilisation for serious illness and injuries and transport to definitive care. ...
care, and outpatient medicine. This may be placed in the arm, commonly either the wrist or the median cubital vein
In human anatomy, the median cubital vein (or median basilic vein) is a superficial vein of the upper limb. It lies in the cubital fossa superficial to the bicipital aponeurosis. It connects the cephalic vein and the basilic vein. It becomes promi ...
at the elbow. A tourniquet
A tourniquet is a device that is used to apply pressure to a limb or extremity in order to stop the flow of blood. It may be used in emergencies, in surgery, or in post-operative rehabilitation.
A simple tourniquet can be made from a stick and ...
may be used to restrict the venous drainage of the limb and make the vein bulge, making it easier to locate and place a line in a vein. When used, a tourniquet should be removed before injecting medication to prevent extravasation
__NOTOC__
Extravasation is the leakage of a fluid out of its container into the surrounding area, especially blood or blood cells from vessels. In the case of inflammation, it refers to the movement of white blood cells from the capillaries to th ...
. The part of the catheter that remains outside the skin is called the connecting hub; it can be connected to a syringe
A syringe is a simple reciprocating pump consisting of a plunger (though in modern syringes, it is actually a piston) that fits tightly within a cylindrical tube called a barrel. The plunger can be linearly pulled and pushed along the inside ...
or an intravenous infusion line, or capped with a or saline lock, a needleless connection filled with a small amount of heparin or saline solution to prevent clotting, between uses of the catheter. Ported cannulae have an injection port on the top that is often used to administer medicine.
The thickness and size of needles and catheters can be given in Birmingham gauge
The Birmingham gauge is a wire gauge system, and is also used to specify thickness or diameter of hypodermic needles and tube products.
Terminology
Birmingham gauge is also known as the Stubs Iron Wire Gauge or Birmingham Wire Gauge. It is not t ...
or French gauge. A Birmingham gauge of 14 is a very large cannula (used in resuscitation settings) and 24-26 is the smallest. The most common sizes are 16-gauge (midsize line used for blood donation and transfusion), 18- and 20-gauge (all-purpose line for infusions and blood draws), and 22-gauge (all-purpose pediatric line). 12- and 14-gauge peripheral lines are capable of delivering large volumes of fluid very fast, accounting for their popularity in emergency medicine
Emergency medicine is the medical speciality concerned with the care of illnesses or injuries requiring immediate medical attention. Emergency physicians (often called “ER doctors” in the United States) continuously learn to care for unsche ...
. These lines are frequently called "large bores" or "trauma lines".
Peripheral lines
A peripheral intravenous line is inserted in peripheral vein
The peripheral vascular system is the part of the circulatory system that consists of the veins and arteries not in the chest or abdomen (i.e. in the arms, hands, legs and feet). The peripheral arteries supply oxygenated blood to the body, a ...
s, such as the veins in the arms, hands, legs and feet. Medication administered in this way travels through the veins to the heart, from where it is distributed to the rest of the body through the circulatory system. The size of the peripheral vein limits the amount and rate of medication which can be administered safely. A peripheral line consists of a short catheter
In medicine, a catheter (/ˈkæθətər/) is a thin tube made from medical grade materials serving a broad range of functions. Catheters are medical devices that can be inserted in the body to treat diseases or perform a surgical procedure. Cath ...
inserted through the skin into a peripheral vein
The peripheral vascular system is the part of the circulatory system that consists of the veins and arteries not in the chest or abdomen (i.e. in the arms, hands, legs and feet). The peripheral arteries supply oxygenated blood to the body, a ...
. This is usually in the form of a cannula
A cannula (; Latin meaning 'little reed'; plural or ) is a tube that can be inserted into the body, often for the delivery or removal of fluid or for the gathering of samples. In simple terms, a cannula can surround the inner or outer surfaces ...
-over-needle device, in which a flexible plastic cannula comes mounted over a metal trocar
A trocar (or trochar) is a medical or veterinary device that is made up of an awl (which may be a metal or plastic sharpened or non-bladed tip), a cannula (essentially a hollow tube), and a seal. Trocars are placed through the abdomen during lap ...
. Once the tip of the needle and cannula are placed, the cannula is advanced inside the vein over the trocar to the appropriate position and secured. The trocar is then withdrawn and discarded. Blood samples may also be drawn from the line directly after the initial IV cannula insertion.
Central lines
A central line is an access method in which a catheter empties into a larger, more central vein (a vein within the torso), usually the superior vena cava
The superior vena cava (SVC) is the superior of the two venae cavae, the great venous trunks that return deoxygenated blood from the systemic circulation to the right atrium of the heart. It is a large-diameter (24 mm) short length vein th ...
, inferior vena cava
The inferior vena cava is a large vein that carries the deoxygenated blood from the lower and middle body into the right atrium of the heart. It is formed by the joining of the right and the left common iliac veins, usually at the level of the ...
or the right atrium of the heart. There are several types of central IV access, categorized based on the route the catheter takes from the outside of the body to the central vein output.
= Peripherally inserted central catheter
=
A peripherally inserted central catheter (also called a PICC line) is a type of central IV access which consists of a cannula is inserted through a sheath into a peripheral vein and then carefully fed towards the heart, terminating at the superior vena cava or the right atrium. These lines are usually placed in peripheral veins in the arm, and may be placed using the Seldinger technique
The Seldinger technique, also known as Seldinger wire technique, is a medical procedure to obtain safe access to blood vessels and other hollow organs. It is named after Sven Ivar Seldinger (1921–1998), a Swedish radiologist who introduced th ...
under ultrasound guidance. An X-ray is used to verify that the end of the cannula is in the right place if fluoroscopy was not used during the insertion. An EKG can also be used in some cases to determine if the end of the cannula is in the correct location.
=Tunneled lines
=
A tunneled line is a type of central access which is inserted under the skin, and then travels a significant distance through surrounding tissue before reaching and penetrating the central vein. Using a tunneled line reduces the risk of infection as compared to other forms of access, as bacteria from the skin surface are not able to travel directly into the vein. These catheters are often made of materials that resist infection and clotting. Types of tunneled central lines include the Hickman line
A Hickman line is a central venous catheter most often used for the administration of chemotherapy or other medications, as well as for the withdrawal of blood for analysis. Some types are used mainly for the purpose of apheresis or dialysis. T ...
or Broviac catheter. A tunnelled line is an option for long term venous access necessary for hemodialysis
Hemodialysis, also spelled haemodialysis, or simply dialysis, is a process of purifying the blood of a person whose kidneys are not working normally. This type of dialysis achieves the extracorporeal removal of waste products such as creatinin ...
in people with poor kidney function.
=Implantable ports
=
An implanted port is a central line that does not have an external connector protruding from the skin for administration of medication. Instead, a port consists of a small reservoir covered with silicone rubber which is implanted under the skin, which then covers the reservoir. Medication is administered by injecting medication through the skin and the silicone port cover into the reservoir. When the needle is withdrawn, the reservoir cover reseals itself. A port cover is designed to function for hundreds of needle sticks during its lifetime. Ports may be placed in an arm or in the chest area.
Infusions
Equipment used to place and administer an IV line for infusion consists of a bag, usually hanging above the height of the person, and sterile tubing through which the medicine is administered. In a basic "gravity" IV, a bag is simply hung above the height of the person and the solution is pulled via gravity through a tube attached to a needle inserted into a vein. Without extra equipment, it is not possible to precisely control the rate of administration. For this reason, a setup may also incorporate a clamp to regulate flow. Some IV lines may be placed with " Y-sites", devices which enable a secondary solution to be administered through the same line (known as piggybacking). Some systems employ a drip chamber
A drip chamber is a device used to allow gas (such as air) to rise out from a fluid so that it is not passed downstream. It is commonly employed in delivery systems of intravenous therapy and acts to prevent air embolism.
The use of a drip cha ...
, which prevents air from entering the bloodstream (causing an air embolism
An air embolism, also known as a gas embolism, is a blood vessel blockage caused by one or more bubbles of air or other gas in the circulatory system. Air can be introduced into the circulation during surgical procedures, lung over-expansion i ...
), and allows visual estimation of flow rate of the solution.
Alternatively, an infusion pump
An infusion pump infuses fluids, medication or nutrients into a patient's circulatory system. It is generally used intravenously, although subcutaneous, arterial and epidural infusions are occasionally used.
Infusion pumps can administer flu ...
allows precise control over the flow rate and total amount delivered. A pump is programmed based on the number and size of infusions being administered to ensure all medicine is fully administered without allowing the access line to run dry. Pumps are primarily utilized when a constant flow rate is important, or where changes in rate of administration would have consequences.
Techniques
To reduce pain associated with the procedure, medical staff may apply a topical local anaesthetic (such as EMLA
Lidocaine/prilocaine is a eutectic mixture of equal quantities (by weight) of lidocaine and prilocaine. A 5% emulsion preparation, containing 2.5% each of lidocaine/prilocaine, is marketed by APP Pharmaceuticals under the trade name EMLA (an ...
or Ametop) to the skin of the chosen venipuncture area about 45 minutes beforehand.
If the cannula is not inserted correctly, or the vein is particularly fragile and ruptures, blood may extravasate into the surrounding tissues; this situation is known as a blown vein or "tissuing". Using this cannula to administer medications causes extravasation
__NOTOC__
Extravasation is the leakage of a fluid out of its container into the surrounding area, especially blood or blood cells from vessels. In the case of inflammation, it refers to the movement of white blood cells from the capillaries to th ...
of the drug, which can lead to edema
Edema, also spelled oedema, and also known as fluid retention, dropsy, hydropsy and swelling, is the build-up of fluid in the body's Tissue (biology), tissue. Most commonly, the legs or arms are affected. Symptoms may include skin which feels t ...
, causing pain and tissue damage, and even necrosis
Necrosis () is a form of cell injury which results in the premature death of cells in living tissue by autolysis. Necrosis is caused by factors external to the cell or tissue, such as infection, or trauma which result in the unregulated dige ...
depending on the medication. The person attempting to obtain the access must find a new access site proximal to the "blown" area to prevent extravasation of medications through the damaged vein. For this reason it is advisable to site the first cannula at the most distal appropriate vein.
Adverse effects
Pain
Placement of an intravenous line inherently causes pain when the skin is broken and is considered medically invasive. For this reason, when other forms of administration may suffice, intravenous therapy is usually not preferred. This includes the treatment of mild or moderate dehydration
In physiology, dehydration is a lack of total body water, with an accompanying disruption of metabolic processes. It occurs when free water loss exceeds free water intake, usually due to exercise, disease, or high environmental temperature. Mil ...
with oral rehydration therapy
Oral rehydration therapy (ORT) is a type of fluid replacement used to prevent and treat dehydration, especially due to diarrhea. It involves drinking water with modest amounts of sugar and salts, specifically sodium and potassium. Oral rehydrati ...
which is an option, as opposed to parenteral rehydration through an IV line. Children in emergency departments
An emergency department (ED), also known as an accident and emergency department (A&E), emergency room (ER), emergency ward (EW) or casualty department, is a medical treatment facility specializing in emergency medicine, the acute care of pati ...
being treated for dehydration have better outcomes with oral treatment than intravenous therapy due to the pain and complications of an intravenous line. Cold spray may decrease the pain of putting in an IV.
Certain medications also have specific sensations of pain associated with their administration IV. This includes potassium
Potassium is the chemical element with the symbol K (from Neo-Latin ''kalium'') and atomic number19. Potassium is a silvery-white metal that is soft enough to be cut with a knife with little force. Potassium metal reacts rapidly with atmosphe ...
, which when administered IV can cause a burning or painful sensation. The incidence of side effects specific to a medication can be affected by the type of access (peripheral versus central), the rate of administration, or the quantity of drug administered. When medications are administered too rapidly through an IV line, a set of vague symptoms such as redness or rash, fever, and others may occur; this is termed an "infusion reaction" and is prevented by decreasing the rate of administration of the medication. When vancomycin
Vancomycin is a glycopeptide antibiotic medication used to treat a number of bacterial infections. It is recommended intravenously as a treatment for complicated skin infections, bloodstream infections, endocarditis, bone and joint infections, ...
is involved, this is commonly termed "Red Man syndrome" after the rapid flushing which occurs after rapid administration.
Infection and inflammation
As placement of an intravenous line requires breaking the skin, there is a risk of infection. Skin-dwelling organisms such as coagulase-negative staphylococcus or ''Candida albicans
''Candida albicans'' is an opportunistic pathogenic yeast that is a common member of the human gut flora. It can also survive outside the human body. It is detected in the gastrointestinal tract and mouth in 40–60% of healthy adults. It is us ...
'' may enter through the insertion site around the catheter, or bacteria may be accidentally introduced inside the catheter from contaminated equipment. Infection of an IV access site is usually local, causing easily visible swelling, redness, and fever. However, pathogens may also enter the bloodstream, causing sepsis
Sepsis, formerly known as septicemia (septicaemia in British English) or blood poisoning, is a life-threatening condition that arises when the body's response to infection causes injury to its own tissues and organs. This initial stage is follo ...
, which can be sudden and life-threatening. A central IV line poses a higher risk of sepsis, as it can deliver bacteria directly into the central circulation. A line which has been in place for a longer period of time also increases the risk of infection.
Inflammation of the vein may also occur, called thrombophlebitis or simply phlebitis. This may be caused by infection, the catheter itself, or the specific fluids or medication being given. Repeated instances of phlebitis can cause scar tissue to build up along a vein. A peripheral IV line cannot be left in the vein indefinitely out of concern for the risk of infection and phlebitis, among other potential complications. However, recent studies have found that there is no increased risk of complications in those whose IVs were replaced only when clinically indicated versus those whose IVs were replaced routinely. If placed with proper aseptic technique, it is not recommended to change a peripheral IV line more frequently than every 72–96 hours.
Phlebitis is particularly common in intravenous drug users, and those undergoing chemotherapy, whose veins can become sclerotic and difficult to access over time, sometimes forming a hard, painful “venous cord”. The presence of a cord is a cause of discomfort and pain associated with IV therapy, and makes it more difficult for an IV line to be placed as a line cannot be placed in an area with a cord.
Infiltration and extravasation
Infiltration occurs when a non-vesicant IV fluid or medication enters the surrounding tissue as opposed to the desired vein. It may occur when the vein itself ruptures, when the vein is damaged during insertion of the intravascular access device, or from increased vein porosity. Infiltration may also occur if the puncture of the vein by the needle becomes the path of least resistance—such as a cannula which has been left inserted, causing the vein to scar. It can also occur upon insertion of an IV line if a tourniquet is not promptly removed. Infiltration is characterized by coolness and pallor to the skin as well as localized swelling or edema. It is treated by removing the intravenous line and elevating the affected limb so the collected fluids drain away. Injections of hyaluronidase
Hyaluronidases are a family of enzymes that catalyse the degradation of hyaluronic acid (HA). Karl Meyer classified these enzymes in 1971, into three distinct groups, a scheme based on the enzyme reaction products. The three main types of hyal ...
around the area can be used to speed the dispersal of the fluid/drug. Infiltration is one of the most common adverse effects of IV therapy and is usually not serious unless the infiltrated fluid is a medication damaging to the surrounding tissue, most commonly a vesicant or chemotherapeutic agent
This is a list of chemotherapeutic agents, also known as cytotoxic agents or cytostatic drugs, that are known to be of use in chemotherapy for cancer. This list is organized by type of agent, although the subsections are not necessarily definitive ...
. In such cases, the infiltration is termed extravasation
__NOTOC__
Extravasation is the leakage of a fluid out of its container into the surrounding area, especially blood or blood cells from vessels. In the case of inflammation, it refers to the movement of white blood cells from the capillaries to th ...
, and may cause necrosis
Necrosis () is a form of cell injury which results in the premature death of cells in living tissue by autolysis. Necrosis is caused by factors external to the cell or tissue, such as infection, or trauma which result in the unregulated dige ...
.
Others
If the solutions administered are colder than the temperature of the body, induced hypothermia can occur. If the temperature change to the heart is rapid, ventricular fibrillation
Ventricular fibrillation (V-fib or VF) is an abnormal heart rhythm in which the ventricles of the heart quiver. It is due to disorganized electrical activity. Ventricular fibrillation results in cardiac arrest with loss of consciousness and no p ...
may result. Furthermore, if a solution which is not balanced in concentration is administered, a person's electrolyte
An electrolyte is a medium containing ions that is electrically conducting through the movement of those ions, but not conducting electrons. This includes most soluble salts, acids, and bases dissolved in a polar solvent, such as water. Upon dis ...
s may become imbalanced. In hospitals, regular blood tests may be used to proactively monitor electrolyte levels.
History
The first recorded attempt at administering a therapeutic substance via IV injection was in 1492, when Pope Innocent VIII
Pope Innocent VIII ( la, Innocentius VIII; it, Innocenzo VIII; 1432 – 25 July 1492), born Giovanni Battista Cybo (or Cibo), was head of the Catholic Church and ruler of the Papal States from 29 August 1484 to his death in July 1492. Son of th ...
fell ill and was administered blood from healthy individuals. If this occurred, the treatment did not work and resulted in the death of the donors while not healing the pope. This story is disputed by some, who claim that the idea of blood transfusions could not have been considered by the medical professionals at the time, or that a complete description of blood circulation was not published until over 100 years later. The story is attributed to potential errors in translation of documents from the time, as well as potentially an intentional fabrication, whereas others still consider it to be accurate. One of the leading medical history textbooks for medical and nursing students has claimed that the entire story was an anti-semitic fabrication.
In 1656 Sir Christopher Wren
Sir Christopher Wren PRS FRS (; – ) was one of the most highly acclaimed English architects in history, as well as an anatomist, astronomer, geometer, and mathematician-physicist. He was accorded responsibility for rebuilding 52 churches ...
and Robert Boyle
Robert Boyle (; 25 January 1627 – 31 December 1691) was an Anglo-Irish natural philosopher, chemist, physicist, alchemist and inventor. Boyle is largely regarded today as the first modern chemist, and therefore one of the founders of ...
worked on the subject. As stated by Wren, “I Have Injected Wine and Ale in a liveing Dog into the Mass of Blood by a Veine, in good Quantities, till I have made him extremely drunk, but soon after he Pisseth it out.” The dog survived, grew fat, and was later stolen from his owner. Boyle attributed authorship to Wren.
Richard Lower showed it was possible for blood to be transfused from animal to animal and from animal to man intravenously, a xenotransfusion
Xenotransfusion (from Greek '' xenos-'' ''strange'' or ''foreign''), a form of xenotransplantation, was initially defined as the transfer of blood from one species into the veins of another. In most cases, it is a transfer of blood between a non- ...
. He worked with Edmund King to transfuse sheep's blood into a man who was mentally ill. Lower was interested in advancing science but also believed the man could be helped, either by the infusion of fresh blood or by the removal of old blood. It was difficult to find people who would agree to be transfused, but an eccentric scholar, Arthur Coga, consented and the procedure was carried out by Lower and King before the Royal Society
The Royal Society, formally The Royal Society of London for Improving Natural Knowledge, is a learned society and the United Kingdom's national academy of sciences. The society fulfils a number of roles: promoting science and its benefits, re ...
on 23 November 1667. Transfusion gathered some popularity in France and Italy, but medical and theological debates arose, resulting in transfusion being prohibited in France.
There was virtually no recorded success with any attempts at injection therapy until the 1800s, when in 1831 Thomas Latta
Thomas may refer to:
People
* List of people with given name Thomas
* Thomas (name)
* Thomas (surname)
* Saint Thomas (disambiguation)
* Thomas Aquinas (1225–1274) Italian Dominican friar, philosopher, and Doctor of the Church
* Thomas the A ...
studied the use of IV fluid replacements for cholera
Cholera is an infection of the small intestine by some strains of the bacterium ''Vibrio cholerae''. Symptoms may range from none, to mild, to severe. The classic symptom is large amounts of watery diarrhea that lasts a few days. Vomiting and ...
treatment. The first solutions which saw widespread use for IV injections were simple "saline-like solutions", which were followed by experiments with various other liquids, including milk, sugar, honey, and egg yolk. In the 1830s, James Blundell, an English obstetrician, used intravenous administration of blood to treat women bleeding profusely during or after delivery. This predated the understanding of blood type
A blood type (also known as a blood group) is a classification of blood, based on the presence and absence of antibodies and inherited antigenic substances on the surface of red blood cells (RBCs). These antigens may be proteins, carbohydrate ...
, leading to unpredictable results.
Intravenous therapy was expanded by Italian physician Guido Baccelli
Guido Baccelli (25 November 1830 – 10 January 1916) was an Italian physician and statesman. One of the most renowned Italian physicians of the late 19th Century, he was Minister of Education of the then young Kingdom of Italy for six times an ...
in the late 1890s and further developed in the 1930s by Samuel Hirschfeld, Harold T. Hyman and Justine Johnstone Wanger but was not widely available until the 1950s. There was a time, roughly the 1910s-1920s, when fluid replacement that today would be done intravenously was likelier to be done with a Murphy drip
A Murphy drip is a rectal infusion apparatus to administer the medical procedure of proctoclysis, also known as rectoclysis. During the procedure, an end of the Murphy drip is inserted into the rectum and large quantities of liquid are infused ...
, a rectal infusion; and IV therapy took years to increasingly displace that route. In the 1960s, the concept of providing a person's complete nutritional needs through an IV solution began to be seriously considered. The first parenteral nutrition supplementation consisted of hydrolyzed protein
Hydrolyzed protein is a solution derived from the hydrolysis of a protein into its component amino acids and peptides. While many means of achieving this exist, most common is prolonged heating with hydrochloric acid, sometimes with an enzyme su ...
s and dextrose. This was followed in 1975 with the introduction of intravenous fat emulsions and vitamins which were added to form "total parenteral nutrition", or that which includes protein, fat, and carbohydrates.
See also
* Banana bag
A banana bag (or rally pack) is a bag of IV fluids containing vitamins and minerals. The bags typically contain thiamine, folic acid, and magnesium sulfate, and are usually used to correct nutritional deficiencies or chemical imbalances in the ...
* Dialysis
* Fluid warmer
A fluid warmer is a medical device used in healthcare facilities for warming fluids, crystalloid, colloid, or blood products, before being administered (intravenously or by other parenteral routes) to body temperature levels to prevent hypothermi ...
* Hypodermic needle
A hypodermic needle (from Greek ὑπο- (''hypo-'' = under), and δέρμα (''derma'' = skin)), one of a category of medical tools which enter the skin, called sharps, is a very thin, hollow tube with one sharp tip. It is commonly used w ...
* Life support
Life support comprises the treatments and techniques performed in an emergency in order to support life after the failure of one or more vital organs. Healthcare providers and emergency medical technicians are generally certified to perform basic ...
* Needleless connector
* Saline flush A saline flush is the method of clearing intravenous lines (IVs), central lines or arterial lines of any medicine or other perishable liquids to keep the lines (tubes) and entry area clean and sterile. Typically in flushing an intravenous cannula, ...
References
Further reading
* Royal College of Nursing,
Standards for Infusion Therapy
'
Archive of the 4th edition (December 2016)
via the Internet Wayback Machine)
External links
*
{{DEFAULTSORT:Intravenous Therapy
Dosage forms
Injection (medicine)
Veins
Intravenous fluids
Medical treatments