How To Administer IV Medication Using Gravity Infusion | Sutter Infusion Pharmacy Services

How To Administer IV Medication Using Gravity Infusion | Sutter Infusion Pharmacy Services


SUE NITTLER: Hi, my
name is Sue Nittler, and I’m a nurse with Sutter
Infusion and Pharmacy Services, a division of
Sutter Care at Home. Today I’m going to show
you how to give your IV medication using the
gravity infusion method. First, gather your supplies
from the pharmacy supply box, and now we’ll get started. Clean the pharmacy instructional
tray with an alcohol wipe. This is the first in
several very important cleaning steps to pay
close attention to. Now gather your
supplies and place them on the instructional
tray in the pictures provided, alcohol wipes,
two saline syringes, a heparin syringe if
your nurse has instructed you to use heparin, your
medication bag, the IV tubing, green alcohol covers,
and if you’ll be using your IV tubing later today, a red cap. Sutter Infusion Pharmacy
provides soap for hand-washing. Go ahead and wash your hands
thoroughly for 20 seconds, getting into all the
nooks and crannies. Now dry your hands
thoroughly with paper towels. Your gravity infusion
medication will be provided in one of these three forms. The first is a pre-mixed
bag from pharmacy. This may be in
your refrigerator. If your medication
is refrigerated, remove it 30 to 60 minutes prior
to your infusion time to warm to room temperature. The second is a pre-mixed
bag from the manufacturer. This will come in a wrapper. Go ahead and open it up,
and remove the medication from the bag. There may be
condensation or moisture on the outside of the bag. This is normal. The third bag is an IV mini bag. You can see that the medication
powder is attached to the bag, and we’ll need to mix the powder
into solution before infusing. Check the medication label for
the correct name, correct drug and dose, and the use by date. Now I’ll show you how to mix
the medication into the IV mini bag. First, break the
neck of the vial. Now hold up the bag and
squeeze the solution into the glass vial. Squeeze it until it’s
about halfway full. Now you’ll gently swirl the
solution to mix the powder in. Mix until it’s completely mixed. Once it’s mixed, flip
the bag upside down and pull the
solution into the bag by squeezing the bag gently. Find the IV tubing, remove
it from the wrapper. Then find the white paper
tape, and remove that. Now uncoil the IV tubing. Find the white clamp
and pinch it shut. Now I’ll attach the
tubing to the bag. First, remove the blue cap
from the port of the bag. Remove the cap from your
spike, and spike the bag. Now hang the bag on the pole. Fill the drip chamber
by squeezing it. Fill it one-third
to one-half way. Find the white dial. The arrow is pointing to open. Turn so the arrow
is pointing to 250. Open the pinch clamp to
allow the fluid to prime through the tubing. If there’s any air bubbles,
prime those out as well, and pinch the pinch clamp shut. Now set your infusion rate to
what your nurse instructed you. In my case, I’m going to set
it to 200 milliliters per hour. Tubing is changed once a day. You may reuse the tubing
for multiple doses so long as you keep it clean. If you’re reusing your
tubing in a 24-hour period, go ahead and take the old
bag off, remove the spike from the old bag. Remove the cap from that bag. Now spike the new bag
with the previous tubing. Now hang the bag on the pole. If there’s fluid in
your drip chamber, go ahead and prime it to
a third to a halfway full, and you’re ready to
run your infusion. If there is no fluid
in this drip chamber, but there is air here, you’ll
need to re-prime the tubing. Go ahead and squeeze
the drip chamber to fill it one-third
to one-half way full. Remove the red cap from
the tip of the tubing, taking care not to touch
the tip with your finger. Now open the clamp and allow
the air to prime through. Once the air has primed
through, pinch the clamp shut, and replace the red cap
on the end of the tubing. Now I’ll show you how to
administer your IV medication. First wash your hands with
the instant hand sanitizer that was provided in
the pharmacy supplies. Scrub thoroughly until the
solution is dry on your hands. Remove the white netting
that’s covering the line. Find the blue cap, and unwrap
it from around your arm. My line does not have
a clamp, but yours may. If it does, go ahead
and open it now. Then work your way down
the extension tubing, find the white
clamp, and open that. Place the blue cap where
you can easily see it. Remove the green cap,
and throw it away. Take an alcohol wipe,
place it over the center of the blue cap, and clean
back and forth for 15 seconds. Take your first saline
syringe, remove the white cap, and throw that away. Place the tip of
the saline syringe into the center of
the blue cap, push, and turn clockwise to
make the connection. Now turn your saline syringe
so you can see the numbers. We’re going to flush the
solution into the catheter by using what we call
a push stop technique. So it looks like this push,
stop, push, stop, push, stop, push stop stopping at
the one milliliter mark. Remove the syringe,
and throw it away. If it’s ever difficult to
push your saline solution into the line, or you
can’t push it at all, stop, check and make sure
your clamps are unclamped, and there are no kinks
or bends in the line. If it continues to
be difficult to push, stop immediately,
and call your nurse. Do not ever attempt to force
solution into your line. Clean the tip of the blue cap
thoroughly for 15 seconds. Now attach your tubing
and your IV line. Remove the blue cap. Place the tip of the
tubing into the blue cap. Push and turn clockwise. Find the clamp on your
IV tubing, open it, and your solution is running. Now you can sit back and
relax while your infusion runs for however long your nurse
has instructed it to run. Once your infusion is
finished, and the bag is empty, go ahead and pinch
the clamp shut. Now disconnect the end of the
tubing from your blue cap. If you’re finished with
your infusion for the day, go ahead and take this all
and just throw it away. If you’re reusing the
tubing again later today, go ahead and take a red cap,
remove it from the package, and place it over the tip of
the tubing to keep it clean. Clean the tip of the blue cap
thoroughly for 15 seconds. Now take your second saline
syringe from the tray, remove the white
cap, and place it into the center of the blue
cap, and you guessed it, you’re going to flush
with a push stop motion, push stop, push stop, push stop. Stop at the one. Remove the syringe,
and throw it away. Clean the tip of the blue cap
thoroughly for 15 seconds. If your nurse has instructed
to use heparin in your line, go ahead and take your
heparin syringe from the tray, remove the blue cap, place
the tip of the heparin syringe into the blue cap,
turn it clockwise, and now you’ll flush. Notice that there are
only five milliliters of heparin in the syringe. So you’ll push stop,
push stop, push stop, stop at the one milliliter mark. Remove the heparin
syringe, and throw it away. Your final step is to take
the green alcohol covers, remove it from the
foil wrap, place it over the tip of the blue
cap, and screw it into place. Now find the clamp on
your extension tubing, pinch it closed. If you have a clamp on your
IV line, close that now. Go ahead and wrap the
tubing back around your arm, and secure it in place
with the white netting. Congratulations. You’ve just completed
your gravity infusion. Your nurse will give you
further instructions if needed. If you have any
questions, please refer to your green and
white pharmacy folder. You can find phone numbers
for both Sutter Infusion and Pharmacy Services and
your nursing agency here. From all of us here at Sutter
Infusion Pharmacy Services, we look forward to
working with you.

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