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Hesperian Health Guides

How to give fluid through a vein (intravenous solution, or IV)

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HealthWiki > A Book for Midwives > Chapter 19: Advanced skills for pregnancy and birth > How to give fluid through a vein



If a woman loses a lot of blood during childbirth, or after a complicated miscarriage or abortion, she needs fluids fast in order to save her life. Take her to a medical center as soon as possible. On the way, you can start an intravenous (IV) drip to give her fluids through her veins. If she is awake and can drink fluids, let her do so, but you can also give her an IV.

Note: Learning to give an IV takes practice. It is not something that can be learned just from a book. Watch someone experienced, and then have someone experienced watch you as you give IVs the first few times.
How to give an IV

  1. Wash your hands well with soap and clean water. Put on clean gloves.
  2. Gather all the supplies you will need:
    a bag or bottle of sterile IV fluids
    You may use
    normal saline,
    lactated ringers,
    or Hartmann's
    solution.
    sterile plastic tubing
    (Some IV solution bags
    come with a tube
    already attached.)
    a sterile IV
    (butterfly)
    needle
    tape
    to hold the
    IV in place
    soap and clean water, or
    alcohol, to clean the skin

  3. Open the sterile package of tubing. Attach the tubing to the bottle or bag, but do not touch the part of the tube that attaches to the bag — it must stay sterile.

  4. Hang up the bag of solution. It should be high enough so that the solution can run down through the tube. You can hang it from a hook on the wall, or, in an emergency, someone can hold the bag.

  5. Let the fluid run down through the tube to get rid of any air in the tube. Tie the tube off at the end so that it does not drip and waste the solution. Some tubes come with a clip to close the tube.

  6. Tie a piece of cloth or a rubber tourniquet around the woman's upper arm. This will make the veins in her lower arm fill up with blood and be easier to find.

  7. Look at her lower arm to find the largest vein you can see.

  8. If you cannot find a large enough vein in her lower arm, re-tie the cloth or tourniquet in the middle of her lower arm and look for a vein in the back of her hand, or just above her thumb at the wrist.

  9. When you have picked a vein, clean the skin with soap and clean water or with alcohol.

  10. Hold the vein steady between the first finger and thumb of one hand. Hold the needle in the other hand and carefully insert it into the vein. Do not try to go very deep or very far inside the vein. When the needle is inside the vein, a little blood should appear in the hub of the needle.

    Lay the needle almost against the skin and slide it into the vein.

  11. Take the tourniquet off the woman's arm.

  12. Untie the tube of fluid and attach it to the needle.

  13. Quickly start the flow of the fluid. There should be a flow control on the IV tube. Let the fluid run in as fast as possible until you have replaced about 2 times the amount of blood that the woman lost. If you think she lost 5 cups of blood, she should get 10 cups of IV fluid. After you have replaced the fluid, continue to give the woman 150 cc every hour until she does not need the fluid anymore.

  14. To keep the needle in place, use tape to hold the tube on the woman's arm.


WARNING!   Do not delay getting medical help.
Inserting an IV can take a long time, especially when you are first learning. Trying to insert an IV before transporting someone to medical help can waste time — this is dangerous. When a woman is bleeding heavily, it is more important to get medical help fast than to insert an IV.

To remove an IV, take off the tape, press a sterile or clean cloth against the place where the needle inserts into the skin, and then quickly remove the needle. Keep pressure on the spot for a few minutes to prevent bleeding.


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