The intravenous or IV push or bolus is a means of delivering additional medication through an intravenous line, administered all at once, over a period of a minute or two. This contrasts with IV drip techniques where medicine is slowly delivered from an IV bag. An IV push has the advantage of being able to give extra medicine, as needed, without having to inject the patient elsewhere, and it can rapidly get this medicine into the body since it’s injected directly into the bloodstream. This technique also comes with noted cautions, since not all medicines can be delivered this way and some may cause extreme irritation or toxically high blood levels of a medicine, if they are given too quickly.
When an IV push is needed, a qualified nurse or doctor may have a few choices as to how to administer it. Some lines are called peripheral, and these are usually lines that aren’t currently being used but are being kept usable through injections of heparin. These locked off lines may be the perfect mode of delivering a bolus, since they forgo the necessity of disconnecting any IV drip lines that may be connected to the patient.
Another option is to disconnect the medicine currently being delivered intravenously to briefly give a bolus. In both cases, the medical worker administering the IV push must make sure the medicine given will not interact with other drugs being administered. If there is a possibility of interaction, other methods for delivering the drug, like intramuscular injection, might be utilized.
One thing emphasized in giving the actual IV push is that the injection must be slow. Not all medical workers are allowed to perform this procedure, and typically only registered nurses or more qualified medical professionals can administer medicine in this way. The possible negative effects of a fast bolus include great irritation to the vein, infiltration of the vein (where medicine leaks into the surrounding tissues), and introducing toxic levels of medicine into the bloodstream. These negatives mean a slow injection lasting a couple of minutes or more is indicated in most cases.
Not all medications are suitable for delivery by IV push, and most hospitals and medical agencies keep a list of those medicines most suited, their conflicts with other drugs, and any special precautions that must be taken when using them. Nurses or other medical practitioners who regularly perform this procedure must know the limitations of it to ensure patient safety. Lists are handy, but personal knowledge of when this procedure is acceptable is even more important.
