MINISTRY OF PUBLIC HEALTH OF THE REPUBLIC OF BELARUS

EDUCATIONAL INSTITUTION
«GOMEL STATE MEDICAL UNIVERSITY»
Chair of propedeutics of internal diseases

Discussion of the chair«_____» 2018

The protocol № _

METHODOLOGICAL RESEARCH

For carrying out of employment with students of 2rd course

on medical care and manipulation technology

Theme: THE PARENTERAL ROUTE OF DRUG ADMINISTRATION

(INTRAVENOUS (IV) INJECTION) (filling the infusion system, intravenous
administration of the drug using the infusion system)

Time:4 hours
 1. STUDY AND EDUCATIONAL GOALS, MOTIVATION, DEMANDS
TO THE INITIAL KNOWLEDGE LEVEL
1.1. The study goal
To study parenteral routes of drug administration.
1.2. Motivation
It is identified that nursing skills are deficient in the diploma preparation of doctors.
Nursing interventions described here will contribute to rectifying this deficiency and
provide a solid basis for acquiring essential nursing skills. This will be useful and
informative, and that it will contribute to the delivery of high quality nursing care.
1.3. Requirements to initial level of knowledge
The student should know:
1. The technique of intravenous (IV) injection.
2. The technique of taking blood from a vein with a syringe.
3. The technique of taking blood from a vein with a vacuum system.
4. The technique of filling the infusion system, intravenous administration of the
drug using an infusion system.
5. The technique of using a peripheral venous catheter.
The student should be able:
1. To make intravenous (IV) injection.
2. Control questions from related subjects.
1. Anatomy of blood vessels.
2. Anatomy of skin and musles .
3. Control questions.
1. Equipment for intravenous administration of a drug using a syringe.
2. Intravenous administration of a drug using a syringe.

4. Lesson course.
During lesson control questions are discussed according to lessons themes.

2. КОНТРОЛЬНЫЕ ВОПРОСЫ
Lesson number 7
1. Equipment for intravenous administration of a drug using an infusion
system.
2. Filling the infusion system.
3. Intravenous administration of a drug using an infusion system.

Lesson number 8
4. Ensuring the necessary speed of drug administration.
5. Replacement of a bottle with infusion solution.
6. Intravenous administration of the drug to the patient during the
infusion period.

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 Материалы для самоподготовки

LESSON №7
1 Equipment for intravenous administration of the drug using the
infusion system.
1. Medical furniture:
• manipulation table;
• table for disinfection activities.
2. A medicine in an ampoule (vial) as prescribed by a medical
specialist.
3. Infusion solution in a vial as directed by a specialist physician.
4. Medical instruments sterile single use:
• infusion system (hereinafter referred to as the system);
• 5 ml syringes; 10 ml with needles size 0.8 \ 40 mm (hereinafter
referred to as a syringe).
5. The dressing is sterile (balls).

2. Filling the infusion system.

 1. Verify the name and dose of the drug on the ampoule (vial)
and the infusion solution on the vial with the entry in the
destination list.
 2. Check:
 • integrity of the ampoule (vial) of the drug and the vial of the
infusion solution, their appearance, shelf life;
 3. Indicate on the vial with the infusion solution the date and
time of opening the vial, the name and initials of the patient.
 4. Handle the hands in accordance with the regulations.
 Main stage
 5. Open the packaging with balls.
 6. Prepare a bottle with infusion solution.
 7. Fill the system:
 • take the package with the system with the left hand from the
manipulation table, open the package, remove the system with
the right hand, place the package in the “Packaging”
container;
 • spread the system with both hands, spreading the fingers of
the left hand on the connector of the system, the fingers of the
right hand on the drip chamber of the system;
 • fasten the injection needle on the connector of the system
with the first and second fingers of the right hand;
 • place the injection sleeve of the system between the second
and third fingers of the left hand, while holding the system
tube with the third, fourth and fifth fingers;

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  • remove the cap from the plastic needle with the first and
second fingers of the left hand, place the cap on the
manipulation table;
 • holding the bottle with the infusion solution with the first
and second fingers of the left hand, pierce the rubber stopper
of the bottle with a plastic needle with the right hand and
insert it into the bottle for the entire length;
 • close the roller clamp on the system with your right hand;
 • turn the bottle upside down and fix it on a tripod;
 • open the air valve of the system with your right hand;
 • fill the drip chamber of the system with an infusion solution
of 1/2 volume, pressing the drip chamber of the system
several times with the fingers of the right hand;
 • open the roller clamp on the system with your right hand
while holding the roller clamp in your hand;
1. • fill the system with infusion solution until a drop of infusion
solution appears on the section of the infusion needle;
2. • close the roller clamp on the system with your right hand;
3. • check visually that there is no air in the system tube;
4. • place the completed system on a tripod.

3. Intravenous administration of a drug using an infusion system.

General Information:
Using the infusion system allows you to enter a large amount of
infusion solution (from 100 ml to several liters per day), without
overloading the cardiovascular system and without causing large
fluctuations in blood pressure. Intravenous drip is more easily tolerated by
patients than jet.
With the introduction of drugs that are destroyed by exposure to light,
infusion systems with a light-tight tube and a drip chamber are used.
The injection site is the superficial veins of the elbow, forearm, back
surfaces of the hand and foot.

LESSON № 8
4. Ensuring the necessary speed of drug administration.

Main stage
1.Connect the infusion system to the vein (technique, see question No. 3).
2. Open the roller clamp on the system with your left hand to make sure
there is no infiltration in the venipuncture area.

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 3. Fix the cannula of the injection needle with one strip of adhesive
tape and the system tube below the injection sleeve with the other
strip.
4. Use the right hand to adjust the speed of drug administration using
the roller clamp on the system.
The rate of drug administration is regulated according to the
prescription of a specialist doctor. (Average drug administration rate
is 60 drops per minute, with nitroglycerin administration, the rate is
6-8 drops per minute).

5. Replacement of a bottle with infusion solution.

Preparatory stage
1. Verify the name and dose of the drug on the vial with the
doctor's prescription.
2. Check:
• integrity of the bottle, the appearance of the drug, its shelf
life;
• the integrity of the packaging of sterile medical instruments
and sterile dressings, their shelf life.
3. Handle in accordance with the regulations.
Main stage
Open the packaging with balls.
Take the ball with your right hand and moisten with an
emergency disinfection chemical agent.
. Take the bottle with your left hand, process the cap and the
upper third of the bottle with a ball.
Place the used ball in the container “Disinfection of
dressings, PPE” or in the appropriate container “Physical
Method”.
Open the central part of the cap with your right hand using an
ampoule knife.
Take the ball with your right hand and moisten with an emergency
disinfection chemical agent.
Treat the ball with the rubber stopper of the bottle, withstand the exposure
time.
Place the used ball in the container “Disinfection of dressings, PPE” or in
the appropriate container “Physical Method”.
Place the vial on an intravenous infusion stand.
Close the roller clamp on the system with your right hand.
Remove the plastic needle with the right hand from the bottle in which the
infusion solution ended, holding the bottle with the first and second fingers
of the left hand.
Holding the bottle with the infusion solution with the first and second
fingers of the left hand, use the right hand to pierce the rubber stopper of
the new bottle with a plastic needle and insert it all the way into the bottle.
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Open the roller clamp on the system, adjust the rate of drug administration,
continue intravenous infusion.
6. Intravenous administration of the drug to the patient during the
infusion period.
Make a kit of the medicine from the ampoule or vial into the syringe in
accordance with the instructions, observing the rules of asepsis.
Close the roller clamp on the system with your right hand.
Treat the system connector with an antiseptic, wait until the antiseptic has
completely evaporated (the exposure time should correspond to the
instructions for use of the used antiseptic).
Take the syringe with your right hand, fix the connector of the system with
your left, pierce the injection connector with a needle, place the second and
third fingers of your right hand on the cylinder flange, the first on the
piston.
Enter the drug slowly, pressing on the cylinder piston with the first finger
of the right hand.
Remove the injection needle from the system connector.
Place the syringe in a container for temporary placement of syringes or in
the appropriate container “Physical Method”.
Open the roller clamp of the system, adjust the rate of introduction of the
infusion solution, continue intravenous infusion.

Literature
Basic:
1. Ослопов, В. Н. Общий уход за больными терапевтического про филя :
учеб.пособие / В. Н. Ослопов, О. В. Богоявленская. – 4-е изд., испр. и доп.
– Москва : ГЭОТАР-Медиа, 2015. – 459 с.
2. T.P. Pronko, K.N.Sokolov, M.A. Lis The Basics of Patient Care, Гродно
2013
Additional:
3. Общий уход за терапевтическими больными : пособие для студентов
лечебного и медико-психологического факультетов / К. Н. Соколов [и др.]. - 6-
е изд., доп. и перераб. - Гродно :ГрГМУ, 2013. – 267 с.
4. Основы ухода за терапевтическими пациентами : пособие для студ.
лечеб. и мед.-психол. фак. / К. Н. Соколов [и др.]. – Гродно :ГрГМУ, 2016. –
277 с.
5. Отработка практических навыков и умений. Эталоны симуляционных
модулей оказания медицинской помощи : пособие для студ. учрежд. высш.
образования, обуч. / В. В. Редненко [и др.]. – Витебск, 2016. – 127 с.
6. Яромич, И.В. Сестринское дело и манипуляционная техника:
учебник / И.В.Яромич. – 4-е изд., - Минск , 2014. – 527 с.
7. Material of lecture.