Equipment used in IV preparation and administration

 Most common form of Parenteral are Injectables

 In order to successfully perform the task, the medical
practitioner must able to select the appropriate equipment,
properly prepare the medication, select the suitable site &
administer the medication using the correct technique.
 Safety checks along the way to ensure that the entire procedure
is performed with absolute accuracy.

Syringe
 Primarily made of plastic and are completely disposable.
 Typical syringe sizes range from 1 mL to 5 mL.
 Larger syringes (10 to 60 mL)
 Syringes are used for IV push and in the preparation of infusions, are made of
glass or plastic.
 Irrigating wounds or body cavities
Drawing large amounts of blood
Aspirating fluid from a patient’s joint or body cavity.
For IV Push
In the prep of infusion
Glass Syringe – old, use before become some medicines are absorbed by plastic
To sterilized, it must undergo autoclave; expensive
Plastic Syringe – less expensive; Disposable

Components of Syringe
The components of a syringe include the calibrated barrel, plunger, flange, and tip.

Barrel
The cylinder that holds the medication and contains calibrations for precise
measuring. The barrel is typically calibrated in milliliters (mL) or cubic centimeters
(cc) but may be also be calibrated in minims (M). Some specialty syringes contain
other calibrations such as the insulin syringe, which is calibrated in Units.
Plunger
A plastic rod with a rubber stopper on one end that seals the medication within the
syringe and flared edges on the other end for maneuvering the plunger. This
apparatus either draws medication in or pushes medication out of the barrel.
Flange
The flared plastic rim on the syringe used for guiding the plunger.
Tip
The part of the syringe in which the needle is attached. Different types of syringe
tips include: the Slip-tip, a smooth tip in which the needle is attached just by
slipping it onto the syringe; and the Luer-Lock tip, which has a threaded end in
which the needle can be locked by twisting. The tip of the syringe must remain
sterile throughout the entire procedure.

Types of Syringe Tip

There may be slight variations in the equipment’s locking mechanisms, preventing
the needle from firmly attaching to the syringe. This may cause leakage of
medication from the syringe and detachment of the needle during the procedure.
Luer Lock – commonly used
Slip tip – more on catheters and feeding tube
Eccentric – medication parallel to the skin of the patient
Catheter tip – more on irrigation tubing

Needles
 Needles are made of stainless steel or aluminum
needle lengths range from 3/8 of an inch to 6 inches
needles come in gauges ranging from 30 to 13 (higher the gauge, smaller the lumen)
 The length of the needle is determined by the route of administration, the site
of the injection, and the amount of adipose tissue over the injection site.
 The location of the injection also plays a role in the selection of needle length.
 After use, needles must be discarded in a designated sharps container
“The higher the gauge, the smaller the lumen”
Parts of a needle
 Lumen: The bore of a hollow needle
 Bevel: The flat, slanted edge of the needle that helps to ease the insertion of
the needle into the tissue; there are finer cuts and different lengths of bevels,
such as a fine tip bevel, which is used for insulin syringe needles. The finer
the cut of the bevel, the less pain felt by the patient and the less trauma to the
patient’s tissue.
 Shaft: The hollow steel tube of the needle through which the medication
passes into the patient
 Hub: The component that facilitates the attachment of the needle to the
syringe; the hub is color-coded for easy recognition of the size and must
remain sterile when assembling the needle and syringe.
 Safety device: A mechanism to shield the needle after use
 A needle’s gauge (G) refers to the diameter of the needle.
 Gauge sizes that are typically used in ambulatory care range from 20 to 27 G.
Note on Needle Gauge
The larger the gauge number,
the smaller the diameter of the needle
Wing Infusion Set
 Also known as “Butterfly Needles”
 The tubing on a winged infusion blood collection needles allows for greater
flexibility when performing blood draws on “difficult” veins.
 Smaller butterfly needles (i.e. 23G)
 Used on geriatric and pediatric patients with difficult veins
IV Catheter
  It is a hollow flexible tube that is inserted into vein or cavity to instill fluids
 Needle like device
Peripheral Venous Catheter – Inserted into the peripheral vein
Last only for 72 hours, must be replaced to avoid infection

Central Venous Catheter – Inserted deeper to the body

-for Total Parenteral Nutrition and Chemotherapy Drugs

Central Venous Catheter Point of Entry:

Subclavian – laceration; lying below the clavicle
Jugular vein – found in neck
Femoral – groin

Multiple Lumen Catheter

o Used separately administer, incompatible drug
o Each lumen exits the catheter at a different location

Midline Catheter
o Longer peripheral catheters that go from insertion site into a deep vein
o Designed to stay in place 1 week or longer

PICC or Peripherally Inserted Central Catheter

o is a very fine line that is threaded through the peripheral vein into the
subclavian vein
o same characteristic of central line
o can be inserted by a skilled nurse at the bed side
Total Parenteral Nutrion
Months or even years

Infusion Devices – are surgically implanted

Infiltration
o Is a breakdown or collapse of a vein that allows into tissues, surrounding
catheter site

Tunneled Lines/ Broviac Catheter

 A type of central line in which Hickman line or Broviac Catheter is inserted
into the target vein then tunneled under the skin to emerge a short distance
away

CANNULA
 A venous cannula is inserted into a vein, primarily for the administration of
intravenous fluids, for obtaining blood samples and for administering
medicines
  An arterial cannula is inserted into an artery, commonly the radial artery,
and is used during major operations. To measure beat to beat blood pressure
and draw repeated samples
Central Cannula
 A central line is an IV that is attached to a vein in the chest. Usually the
cannula is inserted through the chest wall or a neck vein.
 Central veins are much larger than peripheral veins, so when a central line is
used and the cannula is inserted through the chest or neck the tubing can be
wider and so multiple smaller tubes can be inserted through the larger one to
deliver several IV medications at once that are not allowed to mixed
Oxygen Cannula
 Also known as Nasal Cannula
 is a device used to deliver supplemental oxygen or increased airflow to a
patient or person in need or respiratory help
 Consists of a lightweight tube which on one end splits into two prongs which
are placed in the nostrils. The other end of the tube is connected to an oxygen
supply, such as a portable oxygen generator or a wall connection in a hospital
via a flowmeter
Soluset
 The Buretrol or Soluset were in use before infusion pumps and replaced the
syringe system and has a built-in graduated cylinder
fluid is run into the cylinder
nurse can add a drug in the top of the cylinder injection port for dilution and mixing
before it is infused
Parts of Soluset
 Tubing with spike and roller clamp at proximal end, a clamp and rotating
luer lock at the distal end and graduated burette with flexible drip chamber
in the centre.
 The burette possesses an air inlet and injection port on its proximal end
and contains a ball valve in its base.
 The flexible drip chamber below the burette contains a filter in its base
(filter must prevent particles larger than 40µm from passing). Tubing may
also contain a Y-site which provides a port for the administration of
medication.
Method of Use:
 Used to deliver a fixed volume of IV fluid at a fixed rate, sometimes with
added medication.
Infusion Set
 An infusion set is used with an insulin pump as part of intensive insulin
therapy.
 The purpose of an infusion set is to deliver insulin under the skin.
 It is a complete tubing system to connect an insulin pump to the pump user:
it includes a subcutaneous cannula, adhesive mount, quick-disconnect, and a
pump cartridge connector.
Macroset
 A tubing that supplies large drops of fluids, such as 8 to 20 drops/mL
Microset
 A tubing that supplies small drops of fluids, such as 50-60 drops/mL.
Blood Transfusion Set
 are utilized to treat blood misfortune or to supply blood segments that your
body can’t make for itself.
IV Sets
 A spike to pierce the rubber stopper or port on the IV container
 A drip chamber for trapping air and adjusting flow rate
 A control clamp for adjusting flow rate or shutting down the flow
 Flexible tubing to convey the fluid
 A needle adapter for attaching a needle or a catheter
 A catheter, or tube, may be implanted into the patient and fixed with tape to
avoid having to repuncture the patient each time an infusion is given
- Must be sterile, pyrogen-free, disposable
- Use to deliver IV fluids to patients
- 6 inch extensions up to 110-120 sets used in surgery
Lumen diameter of 0.28 cm
Varying size of the diameter achieves the different flowrate

Filter
o remove contaminants
o glass, pants fibers, and rubber cores
o remove virus particles or toxins
o occasionally become clogged, thus slowing expected flow rates
o 5.0 microns (random path membrane ; remove large particles)

The set may be sterilized before use by means of radiation or ethylene oxide

Nurses generally attaching tubing to fluid container, establishing and maintain flow
rate.