When a doctor has prescribed a medicine that will be administered via an intravenous (IV) line in your arm. An IV Push is so named because the medicine is “pushed” into the bloodstream using a syringe during this procedure. Additionally, IV line will need to be flushed.
Flushing is the process of filling the IV tubing with a solution in order to prevent it from becoming clogged (clotting).
According to international infection control guidelines
Check the medication labels and patient identification
Apply proper checking, whether you have the correct patient, correct medication and correct route of administration.
Prepare all your needs beforehand
Place everything you’re going to need on the stainless steel table, like Medication syringe 2 Saline syringes Heparin syringe, if needed Sterile wipes Alcohol disinfectant swab
Remove the syringe cap
Take care and use caution
Gently tap the syringe
This is done to move air to the tip
Push the plunger to remove air and extra solution.
If difficult to push, pull plunger back slightly to break the seal.
Emergency administration during cardiopulmonary resuscitation.
When quicker response to the medication is required (e.g. Furosemide).
Some drugs are metabolized quickly and must be administered quickly to achieve the desired effects, like Adenosine.
Administration of a “loading” dose of a medication to rapidly achieve a desired drug level.
To avoid incompatibility problems when multiple medications are being administered.
IVP of Chemotherapeutic drugs should be given by chemotherapy qualified nurses.
A clear written order must be obtained by a licensed physician before administration of an IV push medication, except during a Code Blue.
A Registered Nurses will be certified to administer IV push medications in accordance with the guidelines of the institutions, the nursing units and with the IV Medication Reference Manual.
The nurse must be knowledgeable regarding:
Compatibility of medication and IV solution
Maximum dosage and rate of administration
Desired therapeutic effects
Possible adverse effects
Appropriate preparation and dilution
Required monitoring parameters
The nurse must ensure the following:
Right dilution/fluid compatibility
Right flow rate
To avoid speed shock, don’t administer a drug in less than 1 minute, unless the order is direct you to do so or if patient is in cardiac or respiratory arrest.
To decrease drug tolerance, slower injection times or grater drug dilution may be required if the patient has:
Decreased cardiac output
Reduced urine output, renal flow, or glomerular filtration rate.
For quickly metabolized drugs.
To define the professionals authorized to administer medications by direct IVP.
To safely administer approved medications intravenously by push/direct route.
DEFINITION: – IVP is defined as the administration of any medication, diagnostic agent or intravenous fluid infused over less than 5 minutes without the use of an infusion device. – IVP can be administered by two ways; directly into a vein or through an existing infusion line.