Skip to content

11/13/24, 7\:18 PM Guide | Administering intravenous (IV) medication

Administering intravenous (IV) medication

Table of contents

Gather equipment

Collect the equipment required for the procedure and place it within reach on a tray, ensuring that all the items are clearly
visible\:
Clean procedure tray
Non-sterile gloves
Disposable apron (optional)
Medication ampoules/vials
Diluent ampoules/vials
Gauze swab or ampoule breaker (if using glass ampoules)
Syringe for medication
Drawing-up needle (also known as a blunt
when drawing up medications from ampoules
Normal saline 0.9% (10 ml)*
Syringe (10ml)*
Sharps container
The patient’s prescription
™
*These are not required if using a pre-
If administering an intravenous medication using an infusion (e.g. because the medication has a slow rate of administration),
you will also need\:
Intravenous
Infusion pump machines and drip stand
23G or 25G needle
Ampoules and vials
An ampoule is a small glass container which contains a single dose of parental medication, usually in liquid form.
Ampoules have a narrow neck which must be snapped to open them.
A vial is a glass or plastic container with a rubber seal which can be penetrated with a needle. Vials may contain
medication in powder form, and the rubber seal allows liquid to be added to the vial using a needle to reconstitute the
medication before use.

Preparing the IV medication

Wash your hands using alcohol gel. If your hands are visibly soiled, wash them with soap and water.
Double-check the prescription and drug calculation with another registered health professional (e.g. nurse, doctor,
pharmacist).
Clean the tops of the ampoules/vials with an alcohol wipe for approximately 15 seconds and set aside.
https\://app.geekymedics.com/osce-guides/clinical-procedures/administering-iv-medication/ 1/511/13/24, 7\:18 PM Guide | Administering intravenous (IV) medication

Prepare a

™
If not using a pre-
1. Use an aseptic non-touch technique to assemble a 10ml syringe and a drawing up needle, then draw up 10mls of 0.9% saline
2. Remove any air bubbles by gently
3. Dispose of the drawing up needle in the sharps bin and put the syringe back in the original packet to preserve the sterility of
the tip of the syringe

Liquid preparations (ampoule)

Intravenous medications in liquid form can be drawn up from their ampoule.
1. Gently tap the neck of the ampoule to ensure all the liquid is in the main body of the ampoule
2. Using a swab, snap open the glass ampoule
The aim is to snap open the neck of the ampoule away from you, try to avoid crushing the top of the ampoule
There is a risk of being cut by broken glass, a specialised ampoule breaker can be used if required
Do not use the medication if it has been contaminated with glass while opening the ampoule
3. Assemble a syringe and a drawing up needle
4. Draw up the required volume of medication from the ampoule; you may need to tilt the ampoule when drawing up the liquid
5. Remove any air bubbles by pulling back slightly and expelling air from the syringe
6. Dispose of the drawing up needle in the sharps bin and put the syringe back in the original packet to preserve the sterility of
the tip of the syringe
7. Label the medication syringe to correctly identify the medication if drawing up several medications or if a drawn-up
being used

Powder preparations (vial)

If a medication is a powder, it must be reconstituted (which involves adding a liquid) before use. Some medications may
have speci
guidelines or online databases (e.g. Medusa).
1. Draw up the correct volume for dilution using an aseptic non-touch technique with a syringe and drawing up needle
2. Remove the plastic cap from the vial
3. Puncture the rubber seal of the vial and gradually
As you inject diluent into the vial, you need to allow an equal volume of air to be released into the syringe to relieve the
pressure building up inside the vial
4. Mix the medication by holding the vial and syringe in place with one hand, taking care not to shake too vigorously; some
medications require swirling action to dissolve fully
Ensure the medication is fully dissolved and no powder is left in the vial
5. Draw up the required volume of the reconstituted medication with the same syringe and drawing up needle by turning the
vial upside down and pushing the existing air into the syringe according to the volume of medication required
For example, if 3mls of medication is required, pushing ‘3mls’ of air into the vial will displace 3mls of medication in the vial
and allow it to enter the syringe; make sure the needle tip is submerged in the medication to allow this to happen
6. Remove any air bubbles by pulling back slightly and expelling air from the syringe
7. Dispose of the drawing up needle in the sharps bin and put the syringe back in the original packet to preserve the sterility of
the tip of the syringe
8. Label the medication syringe to identify the medication if drawing up several medications correctly or if a drawn-up
being used
https\://app.geekymedics.com/osce-guides/clinical-procedures/administering-iv-medication/ 2/511/13/24, 7\:18 PM Guide | Administering intravenous (IV) medication

Additional steps for infusion medication

Medications to be administered via infusion must be added to an intravenous
draw up medicine as above.
1. Open the required intravenous
2. Attach a hypodermic needle (23G to 25G) to the medication syringe
3. Inject the medication into the infusion port on the
4. Gently invert the bag a few times to ensure the medication is evenly distributed in the
5. Make sure this bag is labelled with the medication details appropriately
6. Attach a giving set and prime the line; keep the packet to place the giving set inside once the line is primed to reduce the
risk of contamination before going to the patient
7. Attach the prepared

Final checks

Before proceeding, check the seven rights of medication administration.
1. Right person\: ask the patient to con
prescription. You should use at least two identi
2. Right drug\: check the labelled drug against the prescription and ensure the medication hasn’t expired
3. Right dose\: check the drug dose against the prescription to ensure it is correct
4. Right time\: con
if relevant
5. Right route\: check that the planned route is appropriate for the medication you are administering
6. Right to refuse\: ensure that valid consent has been gained before medication administration
7. Right documentation of the prescription and allergies\: ensure that the prescription is valid and check the patient isn’t
allergic to the medication you will administer

Introduction

Wash your hands using alcohol gel. If your hands are visibly soiled, wash them with soap and water.
Don PPE if appropriate.
Introduce yourself to the patient including your name and role.
Con
Brie
“ T o d a y I n e e d t o a d m i n i s t e r s o m e m e d i c a t i o n
t h r o u g h y o u r c a n n u l a - t h e s m a l l p l a s t i c t u b e i n y o u r a r m . T h i s w i l l i n v o l v e
c a n n u l a u s i n g a s y r i n g e . T h i s s h o u l d n o t b e p a i n f u l b u t y o u m a y e x p e r i e n c e a s t r a n ge s e n s a t i o n a s t h e m e d i c a t i o n s t a r t s

”
Check the patient’s understanding of the medication being administered and explain the indication for the treatment.
Gain consent to proceed.
Check if the patient has any allergies.
https\://app.geekymedics.com/osce-guides/clinical-procedures/administering-iv-medication/ 3/511/13/24, 7\:18 PM Guide | Administering intravenous (IV) medication

Check and

1. Inspect the cannula site for any evidence of leakage, phlebitis or in
2. Clean the ports on the cannula using an alcohol wipe
3. Connect the
has been administered)
The
Observe for signs of swelling around the site or pain during administration and stop if this occurs

Administer the medication

Bolus administration

1. Attach the medication syringe to the cannula
2. Administer the medication by pressing down on the syringe
Check the rate of administration, as this varies for di
3. Flush the cannula (as some medicine may be left in the barrel)
4. Clamp the cannula line or close the cannula port after

Infusion medication

1. Hang the primed bag on a drip stand and connect the giving set to the cleaned and
2. Set the drip rate or set up and use an infusion pump if required
Speci
3. When the bag is

To complete the procedure...

Explain to the patient that the procedure is now complete.
Thank the patient for their time.
Dispose of PPE appropriately and wash your hands.
Document the details of the procedure and the medication administered.

Reviewers

Dr Matthew Size
Consultant Anaesthetist
Stephen Cross
Operating Department Practitioner

References

1. Gloucester Hospitals NHS Foundation Trust. I V D r u g A d m i n i s t r a t i o n R e s o u r c e B o o k l e t . Published in 2021. Available from\: [LINK]
2. NHS Greater Glasgow and Clyde. N H S G G C - I n t r o d u c t i o n t o I n t r a v e n o u s M e d i c i n e A d m i n i s t r a t i o n . Published in 2020. Available
from\: [LINK]
3. National Institute for Health and Care Excellence (NICE). G u i d a n c e o n i n t r a v e n o u s i n f u s i o n s . Published in 2023. Available from\:
[LINK]
https\://app.geekymedics.com/osce-guides/clinical-procedures/administering-iv-medication/ 4/511/13/24, 7\:18 PM Guide | Administering intravenous (IV) medication
Source\: geekymedics.com
https\://app.geekymedics.com/osce-guides/clinical-procedures/administering-iv-medication/ 5/5