Intravenous fluids or iv fluids are the medically modified liquids that are administered in the body through injections in the vein. It is used as the immediate treatment measure for a lot of medical complications, especially dehydration. Intravenous fluids also possess the formulations of specific medications and not just the ability to raise the fluid volume of the body.
Saline as commonly termed as dextrose is the most widely used iv fluid to raise the body’s fluid levels and to maintain the electrolyte and sodium balance of the body. It is also combined with other drugs whenever essential as mentioned later in this article.
What are the different types of iv fluids?
There are three major classifications of iv fluids namely isotonic fluid, hypotonic fluid, and hypertonic fluid. They are used in different conditions of the patient.
- Isotonic iv fluid: the iv fluid has the same concentration as that of blood concentration. The fluid and blood stay in their own position and the concentration gradient does not appear and therefore no fluid enters or leaves the cells. Osmosis does not take place here.
- Hypotonic iv fluid: the concentration of the fluid is less than that of the blood. This results in the generation of a concentration gradient. As the concentration is low in intracellular space, the intravascular solutes travel to intracellular space. Osmosis takes place here. In unmonitored cases of hypotonic iv fluid administration, cerebral edema can be witnessed.
- Hypertonic iv fluid: the concentration of iv fluid is more than that of blood. The concentration gradient appears. The intravascular pressure is less hence, intracellular solutes travel into intravascular space. It may lead to breathing difficulties and vitals fluctuation and hence should be monitored closely.
What are the types of iv fluids preparations?
Colloid preparations: in this, the suspended molecules are bigger than the size which can enter the cell membrane. Proteins are usually the substances that have colloid preparations.
Crystalloid preparation: here the molecules are dissolved and not suspended and can pass through the cell membrane. This is a widely used preparation.
Need for intravenous fluids.
- Dehydration: it is a condition characterized by low body fluid volume due to various health conditions. If body fluid volumes reduce lower than the lower limit of the normal values then it leads to hypovolemia, which further leads to hypotension and low cardiac output leading to hypovolemic shock.
- Electrolyte imbalance: when potassium and sodium levels in the body fluctuate beyond the coping capacity of the kidneys, it leads to mental confusion, orthostatic hypotension, balance issues, and abnormal emotional turmoil. In such cases, iv fluids are an essential and immediate treatment method.
- Excessive blood loss: in case of road traffic accidents, parturition, or childbirth the blood loss is remarkable. To prevent any further imbalances related to the fluids and electrolytes, iv fluids are administered quickly.
- Patient unable to orally administer the fluids: when a patient’s condition is characterized by frequent episodes of vomiting, inability to swallow or dysphagia, fracture of facial bones, etc. iv fluids are the only way to maintain body fluid balance.
- Burns, an unconscious patient, possesses the need for IV drugs too.
Indications for iv fluids.
- Sodium potassium imbalance.
- Vomiting is due to various etiology like pregnancy, food poisoning, and gastrointestinal anomalies.
- Persistent dehydration.
- Overexertion for a longer time period.
- Menorrhagia or excessive menstrual bleeding.
- Renal issues.
- Post surgery.
- Post delivery.
How does a patient present to a doctor when iv fluid is essential?
- The patient has dry, cracked lips, and scaly skin.
- Sunken eyes, stooped posture, dry and pale tongue.
- History of vomiting, and diarrhea.
- Abnormal blood pressure, pulse rate, and respiratory rate.
- Weak, sleepy patient.
- Balance problems and dizziness, headache.
- Signs of injury or blood loss.
- Mental confusion, irrelevant speech, unconsciousness.
- The patient may give a history of low or high urinary output, reduced fluid intake, weight loss, and lethargy which shall be gradual in onset.
Effects of iv fluids on a patient.
- Intravenous fluids are used to quickly restore the fluid balance of the body, hence it is used when all the other methods of treatment usually cannot be used such as oral administration of fluids.
- Iv lines of administration show the quick effect as it skips the first pass metabolism which is carried out by the liver and hence gives 100% bioavailability.
- It helps by quickly elevating cardiac output, reversing hypovolemia and therefore tissue ischemia.
- It also reduces the mental confusion and electrolyte imbalance effects.
- It helps gain back consciousness and higher mental abilities in the patient.
- It has a positive effect on the quicker recovery of patients with contagious diseases and surgeries and iv fluids act as an adjuvant.
Procedure for iv drug administration.
- Iv drug administration is carried out by an experienced nurse, or medical doctor.
- The patient’s age, weight, and height are taken into consideration and the dose is calculated.
- Interval and speed of administration are defined for the patient.
- By taking all the aseptic precautions, the skin to be punctured is cleared and prepared.
- A fine sterile packaged needle is inserted in the vein.
- Connections are made to the fluid bag and flow is managed with the adjuster.
Advantages of iv drugs and fluids.
- It is quick.
- The effect is complete and 100%.
- Treats hypovolemia and such threatening conditions just in time.
- Immediate iv drug administration of drugs can prevent life threatening situations and complications.
- It is efficient.
- Easily administered
- The primary treatment for various conditions.
Disadvantages of iv drugs and fluids.
- It can cause blisters, erythema, and swelling around the site of injection.
- Improper medical handling can lead to air embolism. This can cause serious damage such as heart arrest, ischemia, or other such disorders.
- May be costly for some patients.
- It cannot be done by untrained professionals.
- If aseptic precautions are not taken, it may lead to sepsis and infection.
- Pain, and numbness around the injection site.
- Mentally unstable patients and psychotic patients may not prove to be an indication as they may tend to self-destruct by pulling the tube or needle out.
Risk factors following intravenous fluid administration.
- Skin discoloration.
- Venous collapse.
- Fluid overload.