Intravenous therapy or IV therapy is the giving of liquid substances directly into a vein. It can be intermittent or continuous; continuous administration is called an intravenous drip. The word intravenous simply means "within a vein" but is most commonly used to refer to IV therapy. Therapies administered intravenously are often called specialty pharmaceuticals.
Infusion therapy involves the administration of medication through a needle or catheter. It is prescribed when a patient's condition indicates that it cannot be treated effectively by oral medications. Typically, "infusion therapy" means that a drug is administered intravenously, but the term also may refer to situations where drugs are provided through other non-oral routes, such as intramuscular injections and epidermal routes (into the membranes surrounding the spinal cord).
"Traditional" prescription drug therapies commonly administered via infusion include antibiotic, anti-fungal, antiviral, chemotherapy, hydration, pain management, and arpentera nutrition.
Infusion therapy is also provided to patients for treating a wide assortment of often chronic and sometimes rare diseases for which "specialty" infusion medications are indicated.
While some drugs have been available for many years, others are newer drugs and biologics. Examples include blood factors, corticosteroids, erythropoietin, infliximab (Remicade), inotropic heart medications, growth hormones, immunoglobulin, natalizumab (Tysabri), and many others.
Diseases commonly requiring infusion therapy include infections that are unresponsive to oral antibiotics, cancer and cancer-related pain, dehydration, gastrointestinal diseases or disorders which prevent normal functioning of the gastrointestinal system, and more. Other conditions treated with specialty infusion therapies may include cancers, congestive heart failure, Crohn's Disease, hemophilia, immune deficiencies, multiple sclerosis, rheumatoid arthritis, and more.
By far, the major home infusion therapies are IV antibiotics, prescribed primarily for such diagnoses as cellulitis, sepsis, and osteomyelitis; other diagnoses include urinary tract infections, pneumonia, sinusitis and more.
"Specialty infusion therapy" is a term used when "specialty" infusion medications are administered. However, it also is used to reflect the highly specialized services and level of care that an infusion pharmacy provides to its infusion therapy patients. While there are some infusion pharmacy organizations that focus on providing a limited set of specialty infusion therapies, others provide the wide spectrum of traditional and specialty infusion therapies. The distinction, if any, between the meaning of "specialty infusion therapy" and "infusion therapy" is related to the context of their use.
Method - The rate at which the solution is to be administered by IV infusion can be determined from the procedure formula. The hands are washed thoroughly before assembling the container of IV solution, the IV pole, and the proper tubing with the flow clamp placed in a position directly beneath the drip chamber and clamped. If a bottle with a rubber stopper is used, the protective metal cap is removed, and, with the bottle held securely on a stable surface, the spike of the tubing is pushed firmly into the stopper. To spike an IV bottle with an indwelling vent and latex diaphragm, the metal cap and diaphragm are removed and the spike is inserted into the non vented hole. If a hiss, indicating a vacuum, does not follow, the bottle is contaminated and should be discarded. Non-vented tubing is used with this kind of bottle. A plastic bag of IV fluid is hung on a hook for spiking, the cap is removed by pulling it smoothly to the right, and a non-vented spike is inserted into the port by using one quick, even motion to prevent the escape of fluid. An IV bag with a firm, easily grasped port with a lip to prevent touch contamination may be spiked before hanging by grasping the port firmly; squeezing the bag may expel air and is carefully prevented. After the hanging bag or bottle is spiked, the drip chamber is gently squeezed until it is half full before the tubing is primed. The end of the tubing is held over a sink or wastebasket as the protective cap is removed, and the cap is kept uncontaminated for reuse. The flow clamp is released, and the tubing is allowed to fill with fluid until all air bubbles are expelled; if a back check valve is on the tubing, the valve is inverted during priming. The flow clamp is then closed, the protective cap is replaced, and the tubing is looped over the IV pole so that it does not interfere with venipuncture. Once the needle or intra catheter is inserted and connected to the tubing, the fluid container is hung securely from the IV pole or a hook 3 feet (0.762 m) above the insertion site. The flow clamp is opened, and the proper fluid delivery rate is adjusted by counting the number of drops entering the drip chamber in a minute. Throughout the administration of IV fluid, rate of flow is checked periodically and any necessary readjustments of the clamp are made. IV fluids also may be delivered via IV pump. IV pump tubing is then used, and the flow rate is calculated in ml/hr. ( See Do the Math section.)
Interventions - The technician assembles the apparatus for the IV infusion, spikes the fluid container, primes the tubing, calculates the proper rate for the patient, and ensures that the rate of delivery and asepsis are maintained. The healthcare professional carefully observes the patient for signs of circulatory overload, such as a bounding pulse, engorged peripheral veins, dyspnea, cough, and pulmonary edema, indicating that the infusion rate is too rapid and requires adjustment.
Outcome Criteria - IV solutions administered to maintain normal body fluid levels and electrolyte balance do not overload the circulation when delivered at the flow rate required by the individual patient.
(1) Primary infusion bag
(2) Macro- or micro-drip tubing
(3) Roller type flow control clamp
(4) Secondary infusion bag (piggyback)
(5) Primary infusion line
(6) Secondary infusion line
(7) Y-type connector
(8) To patient veins
Macro-drip tubing delivers 10-20 drops/minute whereas micro-drip tubing dispenses 60 drops/ml . Flow rate of primary and secondary infuscate is controlled manually using the roller type clamps.