How to administer your medication using the IV push method

Hi, I'm Helen and I'm going to walk you through how to administer your medication using the intravenous or IV push method. This is used when you need to give yourself a smaller volume of medication and it's called push because you'll use a syringe to actually push the plunger to release the medication through your catheter and right into your bloodstream. There are 6 steps you'll need to follow, and you can jump to anyone at any time using the chapters below. 

Step 1: Getting started 

Let's start by making sure you're using a clean area at home. You can wash the surface with soap and water or a disinfectant wipe. You can use your SASH preparation mat as a clean work surface. Use soap and water or disinfectant wipes after each use to keep your SASH mat clean. Now go ahead and wash your hands really well for at least 20 seconds. Apply enough liquid soap to cover the entire surface of your hands. Use a nail brush to clean under your nails if needed. 

Rinse your hands thoroughly and dry them with a paper towel or clean unused hand towel and use that same towel to turn off the faucet. If you don't have access to soap and water, use an alcohol -based hand sanitizer. 

Making sure you have a clean area and clean hands during every step is really important to help prevent infection. Next, make sure you've got all your supplies ready to go on your SASH mat or other clean work surface. One medication syringe at room temperature, 2 prefilled saline syringes, 1 prefilled heparin syringe, if ordered, alcohol pads. You'll want to check your medication and label for the correct patient name, correct medication, correct dose, and that it's not expired. And the solution should be clear, consistent in color, and free of any visible particles. If it's not, call us right away. 

You will also want to remove any air from your saline and heparin syringes. Hold the saline syringe with the tip pointing up and press firmly on the plunger while the tip cap is still on until you feel a click or see the plunger move. Then loosen the tip cap and gently push the plunger to remove any air. 

Re-tighten the cap before placing it back down. Hold the heparin syringe with the tip pointing up and press firmly on the plunger while the tip cap is still on until you feel a click or see the plunger move. 

Then loosen the tip cap and gently push the plunger to remove any air. Re-tighten the cap before placing it back down. Once all of your supplies are ready, wash your hands again for at least 20 seconds. If you touch something other than your supplies after washing your hands, you need to rewash your hands or you can use an alcohol based hand sanitizer. 

It's likely you've heard us talk about SASH or SASH to help you remember several of the steps for infusion and we're going to use SASH again today. 

Step 2: Saline flush 

The first part of SASH is the saline, which you'll use to flush your catheter. If you have a double lumen catheter flush as directed by your nurse or pharmacist, go ahead and open the clamp on your IV catheter or extension set. Use an alcohol pad to clean the injection cap for 15 seconds and let it air dry for five seconds. Be careful not to touch the top of the injection cap with your fingers. 

Remove the tip cap from the saline syringe, then push the saline syringe onto the injection cap and twist it clockwise until it's secure. The tip of the syringe is sterile, so do not touch it or lay it down on any surface while the cap is removed. If it does come in contact with something, throw it away and get a new one.  

Push the plunger and slowly to flush the catheter with as much saline as instructed. If you don't know how much to use, call us and we'll confirm. 

Administer your saline flush as instructed by your nurse. This can be done slow and steady or by the pulse method. 

To use the pulse method, push the plunger, then stop for a second and then push the plunger again. When you have flushed all of the saline into the catheter, remove the syringe from the injection cap and discard the syringe as instructed by your nurse. 

One note, if it's hard to push in the plunger during any flush, check to make sure all the clamps are open. And if you have pain, burning, or swelling when flushing, stop right away and call us.

Step 3: Administering your medication 

Now, you're ready to administer your medication. The second part of SASH. If your medication was refrigerated, you need to let it warm to room temperature before you move on. And no shortcuts here. It's not safe to ever use hot water or a microwave to warm your medication. Scrub the catheter injection cap again with a new alcohol pad for 15 seconds and let it air dry for 5 seconds. Be careful not to touch the top of the injection cap with your fingers. When you're ready, take the cap off the medication syringe. Gently push it in until all the air is out. 

Like before, avoid letting the tip of the syringe touch any surface or your fingers. If it does, be sure to clean it well with a new alcohol pad. Push the syringe onto the injection cap and twist it clockwise. Make sure it's really secure. Then slowly push the plunger to administer the medication in the amount of time you are instructed. Once the medication is in, take the syringe out of the injection cap. 

Take a deep breath. You're doing great. 

Step 4: Second saline flush 

Now you do another saline flush, the third part of SASH, and you'll follow the same steps as earlier. Use a new alcohol pad to clean the injection cap for 15 seconds and let it air dry for 5 seconds. Be careful not to touch the top of the injection cap with your fingers. Remove the tip cap from the saline syringe, then push the saline syringe onto the injection cap and twist it clockwise until it's secure. 

The tip of the syringe is sterile, so don't touch it or lay it down on any surface while the cap is removed. If it does come in contact with something, throw it away and get a new one. 

Push the plunger in slowly or use the pulse method to flush the catheter with as much saline as instructed. If you don't know how much to use, call us and we'll confirm. If you were given heparin and told to use it to flush your catheter, continue with these next steps. Otherwise, you can jump right to the final step, which is clean up. 

Step 5: Heparin flush, if ordered 

The heparin flush is the last part of SASH. Use a new alcohol pad to clean the injection cap for 15 seconds and let it air dry for 5 seconds. 

Be careful not to touch the top of the injection cap with your fingers. Remove the tip cap from the heparin syringe, then push the heparin syringe onto the injection cap and twist it clockwise until it's secure. 

The tip of the syringe is sterile, so don't touch it or lay it down on any surface while the cap is removed. If it does come in contact with something, throw it away and get a new one. 

Push the plunger in slowly or use the pulse method to flush the catheter with as much heparin as instructed. If you don't know how much to use, call us and we'll confirm. When you're done, take the syringe off the injection cap and clamp the catheter or extension set. 

Step 6: Cleanup and disposal  

Now your final step is clean up. Go ahead and throw away the used alcohol pads into your trash. You can also throw your used flush and medication syringes in your trash, unless your nurse has told you to dispose of them in your sharps container. Clean your SASH mat and put it away for next time. 

This may all seem a bit overwhelming at first, but once you do this a few times, you'll feel more comfortable. 

And remember, as a Coram patient, our team is here for you 24 hours a day, seven days a week. 

Thank you for watching.