IV Bags for
- Sodium Chloride
- Sterile water
- Dextrose
- Lactated ringers
- Intravenous therapy
I.V. fluids are used to provide patients with crucial electrolytes, fluids and medications that are necessary to save or sustain lives. These fluids offer instant therapeutic effect when given on time. The solutions used during I.V. fluid replacement process are broadly classified into two types – crystalloids and colloids. And the solution itself is administered into the vein with the help of an infusion set that comprises of a glass or plastic vacuum bottle containing solution that is connected to the patient’s vein through a tubing and catheter or needle.
Intravenous fluid replacement plays a major role in the treatment of various illnesses. The intracellular and extracellular spaces inside the body needs to have a relatively constant proportion of fluid and electrolyte balance. When the person is ill, the illness is preventing normal fluid intake or causing fluid loss over the limit, it’s imperative that I.V. fluid replacement is administered.
Application areas for I.V. fluid include
- Accessory cephalic vein
- Basilic vein
- Cephalic vein
- Dorsal venous network
- Dorsal plexus
- Dorsal arch
- Dorsal metacarpal veins
- Great saphenous vein
- Median cubital vein
- Medial antebrachial vein
- Radial Vein
IV Bags (IV Solutions)
1. Dextrose 5% in water
Uses: Hypernatremia, fluid loss and dehydration
2. 0.9% Sodium Chloride or normal saline
Uses: Hyponatremia, resuscitation, fluid challenges, blood transfusions, shock, hypercalcemia, metabolic alkalosis, diabetic ketoacidosis(DKA)
3. Lactated Ringer’s solution
Uses: Burns, dehydration, acute blood loss, lower GI tract fluid loss, hypovolemia as a result of third-space shifting.
4. 0.45% Sodium Chloride or 50% normal saline
Uses: Sodium and chloride depletion, hypertonic dehydration, water replacement, DKA before dextrose infusion and after preliminary normal saline solution, gastric fluid loss as a result of vomiting and nasogastric suction.
5. Dextrose 5% along with 0.45% Sodium Chloride
Uses: DKA after initial half and full strength normal saline solution, hypoglycemia and cerebral edema.
6. Dextrose 5% with Sodium Chloride or normal saline
Uses: Addisonian crisis, hypotonic dehydration, inappropriate antidiuretic hormone syndrome, temporary relief from shock and circulatory insufficiency in the absence of plasma expanders.
7. 3% Sodium chloride
Uses: Severe depletion of sodium and severe dilutional hyponatremia.
8. Dextrose 10% in water
Uses: Correcting significant hypoglycemia, preventing hypoglycemia in case the patient’s total parenteral nutrition ( feeding that bypasses GI tract ) has stopped unexpectedly.
Note: Documentation for a patient who is receiving an I.V. infusion should include the following:
- Date the catheter was inserted
- Time the catheter was inserted
- Type of catheter
- Appearance of catheter
- Site of insertion
- Amount and type of fluid infused
- Patient’s tolerance level
- Patient’s response to the therapy
Electrolytes
Electrolytes play a crucial role in regulating the distribution of water, generating energy, blood clotting, governing acid base balance as well as transmitting nerve impulses.
Crystalloids
Crystalloids are solutions containing small molecules that can easily flow from bloodstream to tissues and cells. Three types of crystalloids exist.
Isotonic crystalloids : These contain almost the same proportion of osmotically active particles as that of extracellular fluids which is the reason why they don’t shift between intra and extracellular areas. The 0.9% normal saline and lactated ringer’s solution are the two most commonly used isotonic crystalloids.
Hypotonic crystalloids : These are less concentrated compared to extracellular fluid, hence tend to shift from bloodstream to cell, resulting in the swelling of the cell.
Hypertonic crystalloids : These are highly concentrated compared to extracellular fluid. As a result, the fluid gets pulled from the cell into the bloodstream. The cell in turn tends to shrink. Hypertonic solutions (colloids) are typically used to increase blood volume. Plasma, hetastarch, albumin and dextran are some of the examples of colloid solutions. Note that the results of colloids may last for several days in case of normal lining of the capillaries. The patient requires close monitoring for bounding pulse, blood pressure and dyspnea during colloid infusion during IV therapy sessions.
