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Discussion

Video on Iv push please....

I've been told to withdrawl back to check for blood return after inserting in the IV, then I've been told that it's not necessary.

Are there any tutorials or videos demonstrating iv pushes? Thank you:)

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  • Expert

i don't recall seeing a video on this or i'd have posted it. check out the links on post #6 of this sticky thread:

fyi. . .i was an iv therapist for many years as well as a practicing rn. i always aspirated to get a see that i was getting a small amount of blood before i injected. i drew back enough to get a little bit of a streak of blood into the clear part of the extension tubing or the base of the syringe. reason: to verify that i am in the vein. every chemotherapy nurse i know of does this too. reason: extravasation is a nasty business and once it happens you're stuck with dealing with it--best to prevent it from occurring. you don't necessarily need to do this with a iv that has iv fluids infusing, but i did just for my own verification as iv lines do infiltrate and still look like they are infusing if they are going at a slow rate. i currently have a picc line for chemotherapy. every nurse who accesses my line aspirates the line to make sure they get a blood return before they flush it with saline or start my chemo infusion. it's a beautiful thing to see that streak of blood coming through the line.

from intravenous therapy: clinical principles and practice, by judy terry, leslie baranowski, rose anne lonsway and carolyn hedrick, published by the intravenous nurses society, 1995:

(page 194) "direct injection, also known as iv push or bolus, is the administration of a drug directly into the venous access device or through the proximal injection port on a continuous infusion. the purpose is to achieve rapid serum concentrations, but this may be accompanied by a greater risk of adverse effects. instead of regulating the rate of administration by the infusion rate, direct injection only requires the time it takes to push the plunger on the syringe.. many drugs have maximum rates at which they may be administered, so the rate of the injection must be timed and the drug injected in increments. because the drug may be incompatible with the infusing solution or heparin may be present in the intermittent device, the vascular access device should be flushed with normal saline before and after injecting the drug."

i'm looking at a couple of books i have that have the iv bolus injection procedure in them and none of them say to aspirate for blood prior to injection, but. . .i would still do it. having worked with ivs for many years, it is still one of the best ways i know to confirm patency of the iv. just be prudent and don't pull up buckets of blood!

I think that you are talking about an IV push Rx am I correct? If that is the case and the pt has a saline lock and is not hooked up to fluids then I usually start off with a 3cc syringe of NS to check for patency and finish with another 3cc after giving the Rx. If they have an IV running everything should be allright just make you you check the IV site before you give the Rx. You should check anyways as soon as you meet the pt to make sure the line has not infiltrated. If you still feel like you need extra assurance and there will be times you do then check the line and pull some back. Better to be extra safe than not safe.

We have a lot of geriatric patients who have the smaller IVs.

If you try to aspirate from a #22, you probably won't get a return. Not because the IV's in the wrong place, but because the cannula is weak and is collapsing.

Aspirating works great for anything bigger than a 22, though.

  • Expert
We have a lot of geriatric patients who have the smaller IVs.

If you try to aspirate from a #22, you probably won't get a return. Not because the IV's in the wrong place, but because the cannula is weak and is collapsing.

Aspirating works great for anything bigger than a 22, though.

Can't say I agree with you there. You won't get anything back on aspiration if a fibrin sheath has formed over the opening of the IV cannula and it is working like a flap. This will happen with IVs that have been in place for more than 24 hours. Also, if you use too much back pressure you will collapse the vein if it is patent. I've been doing IV for years and I've been able to get blood flash from 24 gauge needles very nicely as long as I've done the aspiration gently.

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