IVs, Nurses, and National IV Nurse Day

If you have ever had an intravenous (IV), you know some of what is involved. It takes skill to start an IV as painlessly and effectively as possible. And the work doesn’t end once the infusion begins. Fluids and medications have to be monitored. The IV must be watched to make sure it is working. Blood tests have to be ordered and reviewed, and so much more.

Special types of infusions, such as central lines or PICC lines must be monitored closely. Their dressings have to be changed and infection risk minimized with proper care.

While registered nurses do start and manage IVs, infusion nurses specialize in all things related to IVs. According the Infusion Nurses Society (INS), an infusion nurse is a certified RN who has passed rigorous exams specific to infusion-related care. If successful, the nurses can use the CRNI designation.

In 1980, the United States House of Representatives designated January 25 as National IV Nurse Day.

What Is an IV?

An IV is a system that allows medical staff to provide fluids, medications, and blood products directly into your blood stream through a vein. A small narrow catheter (hollow tube) is inserted into the vein, most often in your hand or lower arm. This catheter is attached to plastic tubing, which in turn is attached to a bag of fluid.

In some cases, the catheter isn’t attached to tubing right away but has a cap instead to close it off. If you need IV fluid or medication later, the cap is removed and the tubing is attached.

Once the catheter is in place, it is covered with a special see-through bandage. This protects the site from becoming infected and so the nurses can monitor the site. They watch for signs of infection or for signs that the catheter is no longer in place. This means the IV fluid will not go into the vein as it should.

There are several sizes of needles and catheters that can be used to start an IV. Bigger needles, or large bore needles, are used in emergency situations as they allow for fluid to enter the blood stream more quickly. Some infusions, such as blood products, also need a larger bore needle so they can flow through the catheter. Narrow catheters would slow down the flow and cause the blood to clot in the tubing.

Modern IV Therapy

Modern IV therapy was developed over the past 100 years or so, although chemists and researchers did explore using intravenous fluids much earlier. In 1831, William Brooke O’Shaughnessy, a newly qualified doctor in Ireland, began to explore the use of intravenous fluids in treating cholera patients. And it’s believed that in 1832, Thomas Latta, a doctor in Britain, performed the first case of resuscitating a patient using normal saline (salty water) through an IV.

But IV therapy didn’t catch on too quickly. The medical establishment condemned its use at first, stating that it invaded the sanctity of the human body. According to an article in Discover Magazine, “Instead, with no small amount of irony, they would continue with the leeches and ingested mercury, flushing the intestinal tract and draining the blood of their sunken eyed patients. As a result, the ensuing six cholera pandemics of the nineteenth century did not utilize O’Shaughnessy’s principle of rehydration therapy.”

Eventually, the medical community did see the benefit of IV therapy and O’Shaughnessy’s work, long after his death. To this day, O’Shaughnessy’s “recipe” for IV cholera treatment is similar to what the World Health Organization recommends today.

IVs Today

Intravenous infusions today are a far cry from when they were first tried. Most importantly, the issue of sterility and infection prevention is foremost in IV care. The area where the needle will puncture the skin is cleaned thoroughly. Only sterile needles and catheters are used to insert the IV.

The whole IV system is a closed loop. There are no openings to the outside air that could introduce an infection. Any time an IV bag needs to be changed or a medication injected into the IV line, nurses use sterile procedures to prevent bacteria from entering the system.

While most people think of IVs as a treatment in a hospital or clinic, there are many situations where someone may have an IV at home. For example, patients on long-term IV antibiotics may be sent home with a home nurse visiting regularly to give the medications. People can also receive IV nutrition at home, as well as other medications.

Intravenous therapy has come a long way since O’Shaughnessy’s and Latta’s attempts to convince their peers that it had a place in medical treatment. Infusion nurses play an important role in IV therapy and in helping patients receive their treatments in a timely and safe manner.

To learn more about invasive devices, including IVs, visit Sepsis and Invasive Devices, part of the Sepsis and… library.

IV Nurses: Working to Reduce Infections and Sepsis