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Pediatric

Pediatric IV Medication Administration Methods

NOTE:Heparin locksare frequently used to administer medications. With a heparin lock, IV fluids are discontinued after medication infusion, and the IV device is flushed with enough diluted heparin to prevent clotting. The amount of diluted heparin administered depends on the size of the IV device but is usually 1 to 2 mL.

Usual methods of medication administration include.

  1. IV push or bolus: Medication is administered manually or by a secondary pump.
  2. Buretrol: Medication is placed in the Buretrol. When this method is used, the medication must be followed by enough flush to remove all medication from the IV tubing. The amount of flush needed is equal to the amount of fluid in the IV line itself (usually 15 to 25 mL).
    Example:To infuse medication in 1 hour: If the medication and the fluid in the Buretrol equal 10 mL and the IV tubing holds 15 mL of fluid, the IV rate would be 25 mL/h or 25 gtt/min. A minimum of 25 mL fluid must be administered to clear all medication from the tubing.
  3. Retrograde method: This method is used when it is desirable to limit fluid intake. The IV line is clamped, and medication is injected at a Y port above the clamped site. This results in the medication’s going "backward" into the line. The displaced fluid goes into a receptacle on the line (these receptacles are commercially available) or into an empty syringe placed at another Y site above the injection site. (To avoid losing medication into the empty syringe, the tubing volume between the medication and empty syringes must be greater than the amount of medication injected.) The line clamp is released to allow infusion. To ensure that the child receives all medication in the IV line, calculate the total volume of fluid to be infused by adding the volume of fluid below the injection site to the volume injected.

To determine the best method of IV medication administration to use: