IV Push (Direct IV) Medication Administration for Nurses

[@mannagarwal5390]

Not just nurses.. these videos are helping me as a student doctor.. thank you ma'am. Very precise.

[@NurseMinder]

Glad it was helpful!

[@zacr8837]

Thank you for this, sincerely, a covid 19 online nursing student lol

[@NurseMinder]

You are welcome!

[@briannastegall]

This is EXACTLY the video I needed. Thank you for taking the time to make this video so detailed. I check off on my IV skills tomorrow and really benefited from seeing this push-pause method.

[@NurseMinder]

Awesome! Now go out there and be amazing :)

[@jodi-annedavidson5348]

Thank you! Very clear and informative. I like that you label the syringe with the medication. I hadn't seen that before. A lot of nurses (I'm a student) just carry the needle without a label and I could see that being an issue, possibly.

[@NurseMinder]

Thank you for taking the time to write. Labelling a syringe or medication cup is policy here. It is not always done in practice, but helps to prevent errors as that last med check is done at the bedside :)

[@PhoebusAmoebus]

Thanks for this. The IV push procedure wasn't explained very well or demonstrated in my interventions class, so it was good to be able to watch it done.

[@NurseMinder]

Awesome! Happy to help

[@marryanngerman7889]

Pll0

[@briannamanniso8553]

With my nursing experience and giving IV medications that need to be removed from a glass vial, I have always used a "straw-filter" first to draw up the fluid out of the glass vial into the syringe prior to administering to a patient. The straw-filter is acting as the "blunt-tip" needle but is used to filter out any small glass particles. Just thought I'd share for patient safety!

[@NurseMinder]

Awesome! I use a blunt end in the video too. Patient safety is first of mind

[@teresagranger1273]

This is such a good clear demo video. Thanks!

[@NurseMinder]

Thanks Teresa!

[@alishbakhan3239]

I did it at home. Very well explained.

[@NurseMinder]

Great!

[@dhitima100fires9]

Thank you. This VDO really helps. I am going to have nursing skill check off in the end of July.

[@NurseMinder]

Awesome!

[@matthewschaible409]

I like how you spelled video!

[@Crazyreviewer123]

Well this was interesting to see how it’s done I wonder is the same stuff like this done using the asthma iv medication called CINQAIR I might be needing that sooner than I thought after battling asthma that Hasn’t stopped since April 17 2021. So I’m defiantly looking into trying a IV med at the hospital and seeing if that might fix the issue I been dealing with for the past year. Wish me luck that this iv med helps me

[@DenisGrigorov]

When administering IVP through infusion line, I noticed some nurses like to pinch the infusion line right above the port so they push the med at the port for 1ml then release the line so NS can flush that 1ml then pinch the line again above the port to infuse another 1ml, etc. Thoughts? I noticed you don't pinch your line but simply slowly push the med while diluting it with NS from the line.

[@NurseMinder]

Hi! Pinching the line above is just another way to funnel the fluid downstream, but if your line has the backflow check valve, fluid cannot move upstream and the pinch becomes redundant No harm. There is also no need to flush the syringe after, but as long as they do not push the new saline filled syringe faster than the medication is to be infused, it is again a no harm situation

[@DenisGrigorov]

@@NurseMinder thank you, that explanation makes sense. Final question to ask- I noticed a nurse one time pinched the infusion line above the port and pushed ALL 2 ml of Morphine SLOWLY into that infusion line downstream, then (after 4-5 minutes) she had opened up that pinched port, is that harmful or no?? Because once she re-opened the port, didn't she bolused ALL 2 ml of morphine SUDDENLY into the patient that was supposed to be SLOWLY infusing over 4-5 minutes? Thank you for explaining.

[@NurseMinder]

Morphine can be give IV push and the slow push rate makes sure the drug is given per agency policy. It is difficult to assess the impact of the situation you describe as there are many variables. Here is what I will share. The rate of the IV solution is less of a concern if the morphine is being admin per policy (i.e push over 2 min) as the only med delivered is what is in the line at the time. If the med is given as a bolus or in a secondary bag, then the rate of the primary line needs to be taken into consideration. It cannot run faster than the med allows (until the med has cleared the IV line).

[@professorxaviour3649]

@@NurseMinder does the saline solution dilute the pain medicine? A lot of nurses like to push 5ml of saline after 1ml

[@marymillard1832]

I recommend using a filter needle when drawing up medication from a glass ampule instead of a blunt needle.

[@NurseMinder]

Yes absolutely

[@kalpzaveri14]

Mam i m pursuing my carrer in bsc nursing...really ur videos help me in great way..please make more videos

[@NurseMinder]

Thank you! I will be making more, needed a break to focus on a few other things, but I will be doing more soon

[@binichh6438]

very helpful.I have an once tomorrow for iv medication administration.

[@sandralovo6901]

Iii

[@elizabethreed5648]

When giving iv push Protonix, I notice veins in neck dancing like heart rate change, looks chaotic, but, I saw this once when just saline flushing prior to Protonix administering. What is this? I know to watch for vessel spasming. Is that what this is? And, why happen w just saline? I am going slowly.

[@NurseMinder]

From what I read, the IV push rate is slow - over 2 to 15 min. If you push any faster you risk inducing side effects: unusually fast, slow or irregular heartbeat, persistent muscle spasms, seizures, persistent diarrhea, abdominal pain or cramping, fever, blood or mucus in your stool, rash, itching, swelling of the face, tongue and throat, severe dizziness, trouble breathing, and changes in the amount of urine

[@AL-et8cx]

Incredibly helpful. Thank you so much for this.

[@NurseMinder]

You're very welcome!

[@dasdr4594]

Is there any book which give information how's to preapere, dilute and give medicine

[@NurseMinder]

I do have some other videos that might help. Are you specifically looking at IV meds?

[@dasdr4594]

@@NurseMinder yes mam

[@iRuunThis]

you need to use a filter needle for the glass vials

[@NurseMinder]

Yes. It is a blunt end filter needle

[@MysteriousPrincess22]

This is a very clear and easy to understand video thank you ! Can you explain to me what is an IV drip ? I don’t understand the difference between an IV drip versus a patient on continuous on IV meds

[@NurseMinder]

I suspect the two terms are used interchangeably. Drip may refer to meds delivered by gravity (which is less common now as everything goes through a pump for patient safety

[@bridgetmonica31]

I had a nurse do a iv push, she did it bloody fast too..then I started to feel puffed and odd..my bp had being 110 over 80..but after this incident it went to 190 over 110..It took 3 days for it to come right...This on top of iv bags.

[@NurseMinder]

The speed of the med admin depends on the medication. Some will go in as fast as we can push it (adenosine comes to mind) and others will be over 1 to 2 minutes typically

[@mbhali_shandu]

How is tramadol IV given slowly , is it given via a bolus or infusion ?

[@NurseMinder]

I would need to see the drug monograph to know

[@rupalshukla1423]

So Perfect and informative

[@NurseMinder]

Thanks Rupal!

[@karahleibovich8386]

Thank you for this! We haven't practiced this in skills lab yet but I'm curious how you know the rate of infusion since I don't remember that being written in the order. Thanks!

[@NurseMinder]

You are welcome

[@NurseMinder]

The rate of infusion is found in the parenteral monograph

[@ryansongco4029]

Thank You so much for your videos! We do not have hands on labs for these skills bc of the pandemic, but this really helped. Also, where did you get your watch?

[@NurseMinder]

Happy to heat they help! My watch is a walmart purchase :)

[@Internetlo]

We have a practicum on this and IVPB but we can’t practice on an actual pump or lab before hand 💀 the Practicum is on the 1st day of school...

[@NurseMinder]

Wow! That sounds like nursing school - behind before you even start. Good lick and I hope this video helped

[@thepalettewhispererasmr1227]

Also, just for the newbie, whenever you are drawing medication from a glass really should be using a filter needle

[@NurseMinder]

That is also what I share in the video, the needle used is a filter needle :)

[@jassinclair6239]

@@NurseMinder tell these people to stop coming for u 😂 U know what you're doing 😉

[@hashimaachi5265]

Where you get this note

[@NurseMinder]

The paper about how to deliver the medication would be found in your organization

[@hmsfr]

Thank you!

[@NurseMinder]

You’re welcome

[@rahulmalviya1197]

Very nice demonstration.

[@NurseMinder]

Thank you

[@reardelt]

Do you need to use a filter needle to remove the glass fragments?

[@NurseMinder]

Yes :)

[@reardelt]

@@NurseMinder Same for vials that contain powder? Does the piercing of the rubber top in a vial produce small latex particles?

[@normaarambula3608]

Thank you

[@christinaglassco4585]

where is there a good reliable parenteral monograph online? I cant seem to find one. Thank you!

[@NurseMinder]

It is more likely with your organization. You would want to follow their policy

[@Ifynwabudike]

Thanks!…how do we give this in geriatric patients; cos direct iv push is contraindicated

[@NurseMinder]

For a specific medication, you need to see what routes are available to you in the drug monograph

[@michaelbriangalvan4074]

I am just curious, did you use filter needle whe you aspirated med from ampule?

[@NurseMinder]

Yes use a filter needle for an ampule to stop any small bits of glass shavings from entering the medication

[@mssburr]

This was a very nice informative video, thanks for sharing! I think it's another great series of videos would be about emergency room procedures, given a lot of people will avoid going to emergency willing team fearing the possible procedures. Some are not sure which type of procedures require you to stay overnight, for other procedures that may be simple taking care of in the same day along the lines of an outpatient procedure. like myself I fell on my left side, and 10 days later I developed swollen lymph nodes under my arm with swollen left breast diagnosis Mastitis. the first doctor told me to take 10 days of antibiotics they gave me extreme side effects and also called the swelling and my breasts to get worse and more infected. I went back and difference doctor that looked at me and told me to go straight to emergency. As the first doctor should have done. now my friend is going to take me to emergency I am freaking out because the doctor said they will possibly keep me can I have no insurance thanks to covid causing my job to shut down permanently. I am hoping that they will just possibly drain the infection, and do IV antibiotics overnight. I can afford to say in the hospital for a long time because I live alone and have no other income I need to find another job very quickly before I become homeless. so I would love to know possible procedures time frame wiseise, or that could possibly happen. thanks again for sharing!

[@NurseMinder]

Great suggestions. Sorry to hear about your experience!! I hope you recover quickly

[@mssburr]

@@NurseMinder Well I went to the clinic and was told to go to Emergency... So I drove to beat the tornados to my friends house so.. We waited for the storms to pass.. I was a wonderful day..lol Once at the ER they took blood, urine, And a CT.. To then tell me I have a mass in my left breast, and possible a spec on my liver.. Which sucks because I have never drank, smoked or done drugs... I eat a clean diet, using herbal healing over pharma... So I am not okay.. I was job searching so I don't loose my house... Until I fells 4 weeks ago... Started swelling.. and now I have cancer... I am freaking out without insurance. I want a second opinion... Because they gave me a script for a narco painkiller which damages the liver.. I didn't fill it... I'm still taking Advil when needed. Not sure what will happen, cause I live alone.

[@lonewolfnh89]

Amazing

[@NurseMinder]

😊

[@SaNa-hv6uq]

Hello Thank you for the great video. How did you do the calculation of how many seconds needs per syringe line to give the medication?

[@NurseMinder]

That is in your drug manual. It will tell you how fast you can give it and from there you determine the speed. For example if I have 1 ml of med and it can be given in one minute, I only give 0.1 ml every 6 seconds (6 sec x by 10 pumps of 0.1 ml will deliver the 1 ml in 60 seconds)

[@SaNa-hv6uq]

@@NurseMinder thank you ❤️

[@nydiagarciapr-unedited]

Iv in eBay

[@bridgetmonica31]

What is the most in ml that can be given as a push.?

[@NurseMinder]

It depends on the medication

[@bridgetmonica31]

@@NurseMinder what about fluid overload

[@StephanieHeald]

Question Why didn't you pinch the .9 running? I remember being taught to pinch the line with the fluids running.

[@NurseMinder]

Great question. The neutral connector that is used does not require it because it takes care of the positive pressure element. No harm to still pinch

[@bre97bj]

loved the video but why didn't you kink the tube while giving the medication

[@NurseMinder]

When there is a back check valve you do not need to do that

[@najamtara9308]

So when we flush with normal saline at the same rate as the medication is that done to prevent bolus or as a bolus?

[@NurseMinder]

Great question. It is pushed at the same rate (or slower) al allow the medication that remains in the line to infuse per the parameters.

[@najamtara9308]

@@NurseMinder thank you also if there is saline in the tubing and we give medication, does this dilute it before going in to bloodstream?

[@NurseMinder]

No. The saline in the line will not dilute the medication. The medication would push the saline forward, not mix with it

[@alaaemad9523]

from where can I get the medication sheet that you've taken your info from it's amazinggggg

[@NurseMinder]

If it is the drug monograph, they are available in the healthcare centers where you work

[@zimm919ang]

How would I do the math using 10ml syringe over 2 minutes? How many lines to push at a time?

[@NurseMinder]

10 ml syringe would not be ideal, if you are drawing up 2 ml, use a smaller volume syringe if you can

[@zimm919ang]

@@NurseMinder no, the order is for 10ml of antibiotics in 2 minutes...iv push

[@MrSanmanbob]

I would not hold the vile with medication sideways when withdrawing the medication . Hold the vile straight up to prevent spillage of medication.

[@NurseMinder]

There will be no spillage - unless you have poked the vial multiple times, then you can experience fluid loss due to the increased pressure inside the vial with the insertion of air

[@donnafonseca1980]

Tammy, I am changing nursing position. I learned a lot of the skills in nursing school needed for the position of Infusion Nurse. However, I was labor and delivery nurse previously so many of the skills weren't needed or used. Any suggestions? Thanks

[@NurseMinder]

Hi Donna, I suspect you have already transitioned at the time of my writing back. The skills will come back. Give yourself the gift of grace ... meaning ... talk to yourself like you would a new nurse and give yourself time to learn and relearn skills that you once knew. Don't be hard on yourself and remember you knew it once, so you can learn it again. :)

[@moniqueloupe8867]

I worked a few months in step down CC soon after school, then after 12 years of doing anything BUT nursing, I worked in psych for 8 months. Today was my first day back at the bedside at an LTACH. Was I ever nervous! I spent the majority of the day doing Accu checks and vitals and shadowing my preceptor. A little before 3 I heard 2 alarms. Now there were alarms going off all day long but these particularly bothered me, so I went to look for them. A patient's vent tubing had come off of her trach and her sats were dropping into the 80s. The nurse she had had never suctioned anyone before, but I spent quite a bit of time with respiratory patients for just a few months 12 years ago. I'm not saying I wasn't nervous this time but the skill did come right back to me and we quickly got the lady in the high-90s again. I also got to teach someone else to do it which always reinforces my own skills.

[@LisaTrusty]

I wish i had a copy of this print out

[@NurseMinder]

What is the handout? If there is one available, it will have a link in the description

[@raizavergara2660]

Do we not have to kink the tube as we push it?

[@NurseMinder]

If your line has a back check valve than you do not have to kink the line. I still do out of habit but the back valve prevents backflow :$

[@oliviaschneider1708]

My husband was just in the hospital and they just pushed the whole vial of morphine in and he started shaking. I wish they would have pushed a little and waited and pushed more. Can you tell your nurse to push meds slowly?

[@NurseMinder]

I do not have the drug monograph in front of me for morphine- and a conversation is always helpful if you have questions about the dose / and side effects

[@pamelaalexander1607]

I just had the same thing happened to me today. All my other nurses did it properly, this particular nurse shot it all in at one time. I got so sick im still feeling ill behind it. I will be reporting her first thing monday morning

[@oliviaschneider1708]

@@pamelaalexander1607 im so sorry that happened. I ask them to put slowly after all the bad experiences

[@oliviaschneider1708]

@@pamelaalexander1607 o gosh. Im glad im not the only one that hates that. Im sorry that happened. I would just tell them from now on to push it slower.

[@rodpardey]

Where do you find a parenteral manual?

[@NurseMinder]

If you work as a nurse, your company will have them printed off, or online - or available through the pharmacy

[@ediannareyesovalle9636]

So helpful thank you!!

[@NurseMinder]

Thank you :)

[@autumnsun8640]

So helpful thank you.

[@NurseMinder]

Thanks for sharing

[@viddaroshinns8258]

Hi, Great video. I have a question . When using an IV filter such as supor 0.2 micron filter as an add on filter not integrated, where is it placed?. I found myself using a giving set where the only option to attach was at end of set where catheter tubing is attached. I then attached catheter tubing to filter. All pretty close to insertion site. While I am here on a gravity fed set , using this filter, the max Gtts/min I could achieve was 76 gtts /min. I needed 80. Any advice appreciated.Thank You

[@NurseMinder]

Yes. There is only one place to attach it and it will be nearest the insertion site. Location is not as important as function :) for the drip rate, it sounds like you are fairly close, the only way to improve rate is to put the IV bag higher or use a pressure bag (to increase pressure in IV fluid and increase rate of infusion). I suspect raising the bag will be your option as pressure bags are used in emergency situations

[@viddaroshinns8258]

@@NurseMinder Thanks for the reply. I thought that maybe the drip rate was a limitation of the filters max output. Thanks again for your speedy response.

[@viddaroshinns8258]

@@NurseMinder . As part of training we buddied up and practiced IV insertion on each other. 20G needle in Dorsal vein. When she placed catheter she achieved flash back but the vein at insertion site swelled up. She removed catheter. There was no pain at any stage. The vein looked quite blue to the wrist. This was first effort for either of us. Either doing or receiving. Procedure went smoothly except for this.Did she go too deep exiting vein but then would there be flashback or was it just general trauma to vein from insertion. Few hours after procedure vein is sore to touch and surrounding area some inflammation. But nothing of any consequence.Any advice/thoughts appreciated

[@NurseMinder]

It happens. Flash is one step, after which you lower the catheter and insert another 1-2 mm. In that process, the needle may puncture through if not lowered

[@haneenabuzarqa1899]

Ty💕

[@NurseMinder]

You are welcome

[@ioletmcfarland3017]

Thank you for your vlog it's very helpful and important thank you so very much

[@NurseMinder]

Glad to hear it is helpful. Thanks for sharing

[@caenterprisellc6922]

I'm still coming down from IV medication.

[@NurseMinder]

Oh my

[@novemberlilt9315]

hi. is 10seconds per tenth's constant?

[@NurseMinder]

Hi. It is too hard to do a constant pressure at this micro level. I do a slow push over a few seconds and rest, allowing the IV to carry the med forward

[@trixietang542]

O-O yo when my doctor was doing my IV and was giving me medicine through it for when I went two days ago because I felt sick THEY DIDN'T WAIT ANY SECONDS they just went full force putting it all in the tube of the IV •~•

[@NurseMinder]

It will depend on the medication. Some can be pushed right in, others will require a slower push

[@lovedog49507]

I took my iron pill at 5 am this morning. It is now 10 am is it ok to drink milk. So, I cannot ever drink milk now ? I just want a half cup of milk for cereal.

[@NurseMinder]

Random

[@DrAnkitJangid]

Good

[@AJ-rb6fn]

Diluting 1g VANCOMYCIN in 200ml normal saline which is to be delivered by IV Drip, does it change the effectiveness as opposed to slow IV Push of over 60mins ?

[@NurseMinder]

What does the monogram say? If you can deliver it using either method, then the question is - what are reasons to select one over the other? Effectiveness is related to the ability of the drug to do its job

[@AJ-rb6fn]

@@NurseMinder the reason for choosing either of the two methods is to ensure that the potency and effectiveness of the drug in eliminating the bacteria from the body is achieved .

[@deniseritter2524]

#NurseMiĂMercyHealthŘÑ*

[@sandrakochoa7184]

You need to wipe Alcohol on the neck of the vial before you snap it open. 4/29/23

[@NurseMinder]

That is a new one to me! Thanks for sharing that tip

[@chheringlossar6725]

Ej

[@NurseMinder]

?

[@thepalettewhispererasmr1227]

Damn girlfriend in an ampule? What is this 1967? LOL love the video, but we move this slow in ER nursing. You never get to see all of your patient.

[@NurseMinder]

Haha. Learning is always slower than practice :). Happy to have another ER nurse in the mix