Page 1 of 4 DESCRIPTION/OVERVIEW Intravenous (IV) therapy will ...

3.4 Two large bore IVs of at least 18 gauge diameter in large veins are required forany emergency situation where large volumes of fluid and IV medicationsmight be required. The antecubital site is preferred. When the patient’s conditionis stabilized, the site should be changed if possible to a site not overlying a jointwith a smaller diameter catheter.3.5 If caustic agents are ordered or anticipated, a central line or a site on the proximalforearm is preferred. Do not choose a site over a joint if at all possible and avoidthe medial antecubital vein unless no other site is available. Caustic substancesshould not be infused through an IV located in the lower extremity. Consultpharmacy for a current list of caustic agents.3.6 In a cardiopulmonary emergency, vasoactive medications (including Dobutamine,Dopamine, Norepinephrine, Epinephrine and Esmolol) may be administeredperipherally, but central access should be established as soon as possible.4. Routine Care4.1 Standard precautions will be used when performing all aspects of IV therapy.Aseptic technique will be used for all venipunctures and dressing changes.4.2 Dressing changes should be done whenever the dressing becomes damp,loosened, soiled, or as needed.4.3 All patients on IV therapy should be monitored for intake and output (I&O).4.4 All IV bottles/bags should be changed at least every 24 hours. All cassettes andtubing should be changed every 72 hours, with the following exceptions:4.4.1 Intralipid, Total Parenteral Nutrition (TPN), Peripheral ParenteralNutrition (PPN), dextrose solution 10%, and tubing of thesesolutions must be changed every 24 hours. TPN and PPN filterswill be replaced with tubing change.4.4.2 Pressure line tubing (arterial, central venous pressure, pulmonaryartery catheter)and flush solution should be changed every 96hours.4.4.3 All bottles/bags and tubings must be labeled with date and timehung.4.5 Peripheral IVs4.5.1 Change sites every 96 hours or as needed. If no alternative site isavailable, it is possible to get one twenty-four hour extension of theIV site if the current site is patent, intact, and exhibiting no signs orsymptoms of infection, phlebitis, or infiltration. An LIP order mustbe obtained for the IV site extension, and the reason for extensiondocumented in the nursing notes.4.5.2 Peripheral IV sites will be assessed at least every four hours foradult patients, and every two hours in pediatrics. The LIP will benotified if signs/symptoms of infection, infiltration, or phlebitis arepresent.4.6 Saline Locks4.6.1 A saline lock is an angiocath in a cannulated vein that is capped offfor intermittent venous access.4.6.2 Site assessments must be documented q 1 hour while medication isinfusing.4.6.3 When the saline lock is not in use, flush q 6-8 hours with normalsaline flush. Refer to unit specific requirements for documentation._________________________________________________________________________________________________________________Title: Intravenous TherapyOwner: Nursing Practice CouncilEffective Date: 7/7/2010Doc. # 2636Page 2 of 4