Purpose, Classification, Location, and Indications of IV Therapy

The first safety standard in IV therapy is that the practitioner must fully understand the purpose, classification, location, and indications of the IV infusion.

1. Definition of Intravenous Therapy

Intravenous therapy is the technique of introducing a volume of solution and medication into a patient’s body via a vein to treat disease, support treatment, and enhance the patient’s health.

2. Purpose of Intravenous Therapy

• IV therapy quickly replenishes lost circulating volume in cases such as dehydration due to diarrhea, severe burns, blood loss, hemorrhage, etc.
• It aids in detoxification and diuresis.
• IV therapy provides nutrition, nourishing patients who cannot eat or drink.
• It delivers medications for long-term treatment.

3. Indications for Intravenous Therapy

• Hemorrhage
• Vomiting, dehydration from diarrhea
• Burns
• Emaciation
• Preoperative and postoperative care
• Certain medical conditions requiring continuous IV therapy, with medications like antibiotics, vasopressors, etc., prescribed by a physician (e.g., in cases of Osler’s disease, lung abscesses, patients in comas).

4. Contraindications for Intravenous Therapy

• Severe cardiovascular diseases (e.g., heart failure, which can cause acute pulmonary edema; high blood pressure, which can lead to acute heart failure or pulmonary edema).
• Acute pulmonary edema
• As directed by the physician.

5. Classification of Intravenous Solutions

IV solutions come in many varieties, corresponding to their therapeutic or supportive roles in treatment. Commonly used IV solutions are categorized into three main types:

• Nutritional IV solutions: Glucose 5%, glucose 10%, glucose 20%, glucose 30%, protein solutions, lipid solutions, and vitamin solutions.
• Hydration and electrolyte solutions: Used to restore circulating volume in cases of dehydration or blood loss. Common solutions include lactate ringer, 0.9% sodium chloride, and 1.4% sodium bicarbonate.
• Specialized solutions: Used for rapid replacement of albumin or circulating fluids.

Other classifications of IV solutions:

• Isotonic solutions:
  • 0.9% sodium chloride
  • 5% glucose
  • 14%o sodium bicarbonate (Na HCO₃ 14%)
• Hypertonic solutions:
  • 10%-20% sodium chloride
  • 20%-50% glucose
  • 5% sodium bicarbonate
• Large molecule solutions:
  • Dextran
  • Subtosan
  • Plasma, blood.

6. Injection Sites for IV Therapy

For children, IV infusion is typically administered into:

• Scalp veins, forehead veins, temporal veins
• Jugular vein
• Dorsal hand veins, forearm veins, and tibial veins (for older children)

For adults, common IV sites include:

• Veins in the elbow crease (M-shaped veins), forearm veins, and arm veins
• Dorsal hand veins, dorsal foot veins
• Central veins (for measuring central venous pressure, inserting long-term nutrition catheters)

In IV therapy, the dorsal hand vein is frequently used.

Source of information: Bach Mai Medical College (Hanoi)

=>> READ MORE: IV THERAPY SAFETY STANDARDS

• Principles to follow in IV therapy
• IV therapy procedures
• Understanding potential side effects of IV infusion
• IV therapy safety checklist