 Hi everyone and welcome back to the vlog and thank you so so much for tuning in as always. Thanks for taking the time out to come and watch these videos. So I had a lovely request again to do an IV vlog. I was a little bit dubious about this because I've never really done IVs. I am a GP-ness and we don't really see it in GP and then when I was a student the final year of student life actually I never saw an IV as such. We dealt with a lot of syringe drivers which technically is an IV but not like the drip stands and things like that that you get on the wards. So I'm going to warn you now I'm not 100% good with IVs however I have gone back through my notes and I have done the research to be able to do the vlog today and all of the links below for you. Have a look at them because there's some really good links there about IVs, different types of cannulas, drip rates and those sort of things. So yeah look at the links below but I'm going to teach you hopefully some things about IVs today. And something I barely ever ever do for a vlog is make notes but I have actually made some notes and examples and I have my laptop just in case because I am not 100% confident with IVs so I'm going to teach you what I've learned and what I know already from placements and things like that and hopefully we'll get there. So what is intravenous therapy or IV for short? So basically it's just a means of delivering any type of fluid, nutrition, medication straight into your body through the vein and why are IVs used? Well it's a really quick fast access for those that really really need it. Like I said is to give things like fluids of someone really dehydrated it's a quick access just to get them hydrated again before it starts causing other problems. It's also used not just for fluid and water but things like glucose, salt, electrolytes and blood transfusions as well for those that need it. And IVs are usually sort of used in if someone's had an accident for example like a really severe accident. It can be used for procedures or surgery. Someone that's had like a real loss of fluid so if they've got severe diarrhea and vomiting, if they've got severe sweats and they're losing all of that electrolytes and the waters and things like that then they need to replace those. And also anyone that's had a lot of blood loss as well they'll have that blood transfusion as well. Different types of IV therapy, the standard IV stand that everybody thinks about. You might have seen these before, you've seen them on tele if you haven't seen them in real life. Next we have a syringe driver which I'm going to put photos here and this is like I said normally given to palliative care or end alive patients and this is just to help them make them feel more comfortable. So it'll be a syringe inserted into a machine that slowly inserts that medication bit by bit over so many hours and it'll be set up to do that. And normally this is morphine, there's anti-sickness in there. Sometimes there might be something to help settle anxieties in patients because some patients get really anxious and anxiety and a little bit erratic when it comes to that sort of stage so something in there just to settle them which just really really helps the patient and give them that that good quality of life at the end. And then we have a PCA so patient controlled analgesia it is what it says on the tin, put the picture here again. But this is a machine that the patient controls so it's set that they can't press it any more times than sort of every five minutes and it'll give so many mills of morphine or a drug whatever they're on per five minutes so they can press it and they can press it as much as they want but it'll only give the medication every five minutes just to prevent an overdose or anything like that. So that's the PCA type of thing. And then you have things like the bolus like I said so this is just I don't I'm using the hand just for an example just because it's easier but this is literally just straight into the cannula over a set period of time like a couple of minutes and it's just a syringe that will just slowly go into straight into the vein and into the body. And lastly but not least we have a pick line which is more inserted if someone needs long-term therapy so if they need it long-term rather than just a quick fix kind of thing which is changed every so often and that's just used to give again fluids medications anything that person needs. How is this delivered? So this is delivered through a cannula or you might have heard the word venflon I think it's pretty much the same thing but it's like a little needle with different ends to it that goes straight into the vein and they will attach something to it to put that fluid in. So sometimes it's just a syringe and sometimes you're attached to a drip or a syringe driver or a PCA for example. So there's all these different ways that you can do these things and it just depends again on the person and what they're having and why they're having it it depends on what type of cannula that they might put in but nice have broken it down to four types of cannula that you can have so first up we have a ported cannula so this is a little needle and I have a port on it to do different things with and you can have the non-ported cannula and this will either have little wings at the side or non-winged so you can have either and I think these are more used for the IV drips because it's connected straight onto the IV drip or maybe if you're giving a syringe it via syringe into the tubing and the cannula and the veins and all that jazz. The integrated cannula so this cannula is something that it's like a little needle it's got the ports but it has different ports on it for different things so you might want to take blood from one port and you might want to give medication in another port they can't be used from the same port and this is just because it can get clogged up with medications and things like that and you don't want to be taking blood from something that's had medication in it if that makes sense because it might affect the results so yeah so that's why they have the different ports for different things and like I said there are different ways of doing IV so you might have a drip stand I'm going to talk about drip rates and things like that after or you might have a syringe so sometimes IVs are given over a couple of minutes which is normally called the bolus so if you hear the word bolus you know it's going to be sort of a quicker two minutes sort of jobby or five minutes sometimes so I've seen a mentor that's actually had to look at the clock and time how long she's doing the syringe for and she's been there for ages with it or you can have the drip stand and or syringe driver and it's given over a period of a few hours or 12 hours 24 hours whatever but they're just the timings there's all different times for different things it just depends again what the patient's having why they're having it and the route that they're going to give it so what are the risks of having an IV so the obvious ones are infection anything you're going to put into the body that's a foreign object there's always that risk of infection which is why it's a septic technique there's the risk of collapsing veins there's also a risk of not being in the vein properly and the fluid that you're putting in can leak out into the tissues I have seen this happen before where that the patient I think has just moved or something and it's knocked and then it's come out a little bit so then the whole arm has started swelling because the fluid is going into the arm and that's not pleasant I don't think for somebody and with anything you can get some pain as well with it and then lastly you can give somebody too much fluid and I'm assuming that this is more with if you're inserting something too quickly or if they've got some fluids going in and it's running too quickly you can overload the body so that's the last thing you want to do with anyone so make sure that your drip rates are right getting the right amount of fluid for their body weight little things like that so if your patient is having some IV therapy fluids and they start complaining of shortness of breath and they can't breathe and maybe some pain maybe some ankle swelling, leg swelling, swelling on the hands things like that that's a good indicator that something's gone wrong and they might be overloaded with fluids so you want to stop that as soon as possible any signs or symptoms of anything realistically you want to stop as soon as possible and assess the situation before restarting it which leads me nicely on to drip rates now we've all had the drug calculations if you haven't had your drug calculations yet I did do a vlog actually about drug calculations so have a look at that but I'm putting some links below as well that are the end I've got a really good one more specifically to drop rates and flow rates and all of that jazz it's really really good have a look this is where I've got all of my information from so yes here we go a flow rate is the volume in millilitres divided by the time in hours and the drop rate is the drop factor times by the volume divided by 60 times by the time in hours I know but what is the drop factor so the drop factor is how many drops per millilitres of fluid so how many drops does it take to make up that millilitre of fluid and normally it's either 20 or 15 if it's 20 drops then that's normally like the clear fluids that you get but if it's 15 drops it's more of a thicker fluid if that makes sense so things like blood for example might be 15 drops per minute but when we did our IV training at uni it told you on the bag that it gave you that details actually on the bag so have a look at that and if you're not sure have ask your mentor of course or anyone that's around you so the flow rate is quite simple it's volume in millilitres divided by hours and that's your flow rate that's it so let's go on to drop rates and I'm going to give you an example so if you have 100 millilitres in fusion if it's running at 42 per minutes and you're assuming that it's 20 drops per millilitres what is the equation I hope that makes sense so you've got 100 millilitres 42 minutes and 20 drops per millilitres pause it work it out and see if you get it right so your drop rate is 42 and your drop factor is 20 drops per millilitres so you do 42 divided by 20 which will give you 2.1 millilitres per minute and then because you've got your 2.1 millilitres per minute now you can do the 100 divided by the 2.1 millilitres which gives you 47.6 minutes that's your answer I hope that makes sense but all the links are below please have a look because this example is on there I've literally taken it from the RCN just to give you an example and try and explain it a little bit better but it's it's simple when you see it honestly guys it's fine and next IV flushes so you might have seen this happen as well out there I've seen it a few times so why do they do this so basically they do this to prevent medications and things like that clogging up in the tube it's also to help deliver some medications as well into the vein and also to help make sure that different medications don't mix together so if someone's on a few medications through an IV line if they're doing it bolus then they might flush it just to make sure that it's all clear for the next medication so that they don't mix or interact or anything like that so I think that's it for IV therapy I feel like this has been a really quick winded vlog I'm really sorry guys I can't think of anything else like I've done the what is it why do you use it what situations you use it drip rates flow rates what types all of that jazz I can't think of anything else but if there's anything I've missed and you really really want to know this burning question or answer just put a comment below and I will try my best to answer it or find the answer for you but have a google guys everything's on the internet now you can find the nice guidelines you can find RCN things like that nmc all that jazz everything is accessible online now so please read guidelines and follow nice procedures and all of that jazz before anything else again links are below have a look but for now I'm going to say goodbye and I hope you all have an amazing week and I shall see you next time