Intravenous (IV) Therapy

Intravenous (IV) therapy is a method of administering fluids, medicine, nutrition, or blood directly into the bloodstream via a vein.
IV therapy involves inserting a tiny plastic tubing (cannula) into a vein, inserting a needle, and connecting the set-up to a bag of fluid.
The pieces are referred to collectively as an "IV."

Water, glucose (sugar), and electrolytes are frequently found in IV fluid (potassium, sodium, and chloride).
An IV may allow more than one fluid to be administered at the same time and in the same location. 

Your doctor will determine what type of fluid you requires, how much is required, and how quickly (flow rate) it is administered.
The decision is based on your weight and overall health. 

Starting the IV

• A cannula (a tiny plastic tube) is inserted into a vein in your hand, arm, or foot. Inside the tube is a needle that helps guide it into the vein.
• When the needle first penetrates the skin, you will feel a little "stick". Once the cannula is in the proper position, this needle is removed.
• The remainder of the small tubing is taped to the skin to keep the cannula in place.
•  The tiny tubing's open end is then connected to a larger tube and hooked to a fluid bag. The IV now has the ability to transport fluid from the IV bag into the vein.
  
• Unless the cannula moves, you should not experience pain while it is in the vein. To avoid this, a padded board can be taped under the arm or leg to prevent the limb from bending. Bending may also cause the vein to swell and the IV to come out. 
• Sometimes an IV is only required for a few minutes to administer medication.
  A special needle without a cannula may be used in this case. As soon as the medicine is administered, the needle is removed. 
• When a child is younger than one year old, the cannula is sometimes inserted into a vein in the scalp just beneath the skin. This requires that the veins be visible. If your baby has a lot of hair, it may need to be clipped to make it easier to see the veins. Once in place, the cannula is taped to the scalp to keep it still. If the veins are difficult to locate, the IV may need to be started more than once.
  
• If there are any indications of a problem, the IV will be taken out.

 

Taking Care of a Baby With an IV

When you first start holding your baby, you may feel awkward.
It will become much easier very quickly.

• As much as possible, hold, cuddle, and play with your baby. The baby can still play despite having an IV. 
• When bathing your baby, avoid getting the cannula and taped areas wet. Before bathing, ask the nurse to assist you in wrapping the IV.
• To keep the IV from moving, you may need to gently hold your baby's hands at times. 
• Make sure the IV tubing is not caught, pulled, or blocked when you place your baby back in the crib. Examine your baby to see if he or she is lying on the tubing. Drape the tubing over the bed's side rails so that it hangs freely. 
• Do not allow your baby to stand if the IV is in his or her foot.
• Do not lay your baby's head on the side where the IV is if it is in his or her scalp.

 

Taking Care of a Child With an IV

• With an IV, your child can still play, read, and do other things they enjoy.
• When your child bathes, keep the cannula and taped areas dry. Request that the nurse demonstrate how to do this. 
• Check that the tubing is not caught, pulled, or blocked when your child gets in and out of bed or walks around.
• Your child should avoid sitting or lying on the IV tubing.
  
  
  

Controlling the Fluid Rate

Iv drip intravenous infusion pump

An infusion pump regulates how much fluid enters your child's vein each hour. The IV tubing is inserted into the pump. The pump is set to the speed (flow rate) required to provide your child with the appropriate amount of fluid. The machine detects changes in flow rate and sounds an alarm. This alarm prompts the nurse to adjust the flow rate.

 

While the IV is inserted into the vein

The nurses will check on your child every hour, whether he or she is awake or sleeping. To ensure that there are no problems, they will touch, look, and compare the IV site to the other arm, leg, or side of the scalp.

The following are the two most common issues: 

• Infiltration. This is when the cannula is removed from the vein and the IV fluid is injected into the skin tissue rather than the vein. 

1.  Puffiness, redness, and pain are all symptoms of infiltration. These signs will eventually fade away.
2. If there is infiltration, the IV is removed and restarted in a different location.
3. To help reduce puffiness, the nurse may apply warm or cold compresses to the affected area. 

• Irritation of the skin near or inside the IV site (phlebitis). 

1. Redness, itching, puffiness, or pain are symptoms of skin irritation and phlebitis. 
2. Antibiotics, calcium, and nutritional formulas are the fluids most likely to cause phlebitis (parenteral nutrition - PPN or TPN). 
3. If irritation or phlebitis develops, the IV is removed and restarted in a different location. 
4. To soothe your child, the nurse may apply warm compresses to the affected area. 

 

When to Contact a Nurse
Make sure to contact the nurse if:

• The pump's alarm goes off.
• Your child tugs and pulls on the tubing.
• You discover blood in the tubing.
• The tubing separates.
• The tape holding the tube in place comes undone.
• The IV site appears to be red or puffy.
• The area appears to be wet.
• Your child is complaining that the IV is painful.  

  

 When the IV is removed

When your child's IV is no longer needed, the nurse will remove the tape and cannula.
Peeling off the tape will feel similar to removing a Band-Aid®.
When the cannula is removed, your child may feel a slight pinch. 

• Where the IV was inserted, there will be a very small mark and possibly some blood.
  The nurse may apply a Band-Aid and apply pressure to halt the bleeding.
  To reduce the risk of choking and skin damage in children, the Band-Aid will be removed as soon as the bleeding stops.
• Your child's arm or foot might feel a touch stiff if a cushioned board was used to hold the limb immobile. With movement, this will become better for your child.