INTRAVENOUS PREPARATIONS AND METHODS FOR ADMINISTRATION
Section I. INFUSIONS
Ideally, a person gets the fluids and electrolytes needed to live by the oral route.
This route has certain built-in safeguards against bacterial invasion. When the
intravenous route of administration must be used, the material being given is injected
directly into the circulatory system through the veins. Although, this route is certainly
effective in terms of getting the fluid into the patient, the intravenous route is not
completely safe. Complications (that is, infection) can happen. In the case of infection,
the fluid being administered, the intravenous administration set (the equipment between
the bottle or the bag and the patient), and the techniques used to start the fluid
administration are possibilities for bacterial contamination. The intravenous
administration of fluids is to be taken seriously.
You may have seen intravenous solutions being administered to a patient. The
bottle or bag connected to the patient by a plastic tube means life to many patients.
a. Intravenous Solutions. Intravenous solutions are products that meet certain
rigid requirements and are supplied ready for use by manufacturers. Examples of such
intravenous solutions are five percent dextrose, 0.9 percent sodium chloride, and
lactated Ringer's. These solutions are ready for use as soon as they arrive from the
manufacturer. You will see the lactated Ringer's and the 0.9 percent sodium chloride
used as "to keep open" (TKO) solutions. They serve as a ready and rapid way by which
drugs could be given to the patient should the patient go into shock. These solutions
serve as a "base" for the admixtures.
b. Intravenous Admixtures. Intravenous admixtures are intravenous solutions
to which have been added one or more drugs. For example, it is common for a patient
to be administered a liter of five percent dextrose which has 20 mEq of potassium
chloride added to it. Thus, the patient received fluid, nutrients (dextrose), and
electrolytes (potassium and chloride). Typically, patients receive much more
complicated intravenous admixtures. These intravenous admixtures are usually
prepared in the Pharmacy Sterile Products Section by specially trained personnel who
use aseptic techniques. At times, it may be necessary for the physician or the person
administering the infusion to add one or more drugs after the solution is already in
place. This is done only on the physicians order.