IV Medications (Addictives)

The first seven steps here are exactly the same as IV Medications (Bolus). The two procedures are just slightly different.

Things Required:

• IMR
• Medications (usually powdered form)
• Diluent (eg. H2O for injection)
• Normal Saline
• Syringes
• Needle
• Gloves
• Alcohol swabs
• Gauze
• Kidney dish
• IV set (if patient does not have an existing IV line running. If antibiotics are to be given, the IV should have a burette attached to it.)

Always check the items you take for expiry date and clarity (if applicable).

1. Check whether the order for that medication is a first dose for that patient. If it is the first dose, doctors are to administer them. Verify order and patient's need for this procedure.

2. Perform hand rub.

3. Withdraw an appropriate amount of diluent eg. 10ml (depends on what medications you are giving and the hospital policy/ guidelines) into a syringe. Ensure that there is no bubbles.

4. Swab the top of the medication bottle with an alcohol swab. Attach the needle to the syringe and inject the diluent into the medication. Dissolve the medication well by rolling the medication bottle in your palms, rather than shaking, which would introduce bubbles.

5. Withdraw the dissolved medication into the syringe and throw the needle into a sharp box.

6. Depending on hospital policy, withdraw 6-10ml of normal saline into another syringe. Place the IMR, syringes, alcohol swabs, gauze and gloves into the kidney dish before approaching patient.

7. Approach and identify patient with 2 patient identifiers again: patient’s name and IC by asking patient and verifying it with his wrist tag. Ensure that patient is not allergic to the medication by checking it with the IMR and by asking patient. Prepare the environment where necessary.

8. If patient do not have an existing IV line that is used for less than 72 hours, prepare a new IV set by priming it with normal saline. Inject the medications into the IV set and adjust the flow rate.

9. Attach a sticker stating the medication/ addictives added, the amount of addictives added, the date and time when it was added and your name to the IV set.

10. Document the procedure in the IMR and relevant notes. Note for patient's response and any adverse effects to the medication.

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