IV Discontinuation: Guidelines and Best Practices

IV fluid administration may be discontinued for several reasons. The most usual reason for stopping IV is when a medical doctor orders so after a patient has attained euvolemia and the patient is able to maintain sufficient oral fluid intake or when the patient is being discharged from hospital. Also, IV may be discontinued if the IV is dislodged, or the site of insertion shows signs and symptoms of infiltration, infection phlebitis, or extravasation. I.V infiltration occurs when I.V medication or fluid leaks into the neighboring tissues generally as a result of dislodgement or improper placement of the catheter; while IV extravasation is the leakage of IV fluid into the extravascular tissue around the infusion site

Before IV discontinuation, a nurse should obtain an order from a medical doctor. The nurse then correctly identifies using the patient's name and record number and informs the patient of the procedure. The nurse then collects supplies such as alcohol, tapes, and gauzes before conducting hand hygiene and cleaning or disinfecting the gloves to be used. The nurse then peels the transparent dressing off using alcohol, starting with the edges to make the process easier and to cause less pain to the patient. After the bandage is removed, the nurse uses fresh alcohol to wipe and swab on the areas around the catheter and injection site. The nurse then pulls out the catheter and applies a gauze pad over the site and uses tape over the gauze pad. The nurse should keep steady pressure on the site for about 2-3 minutes to stop the bleeding.

However, pressure should be applied for longer if the patient is using anticoagulant drugs. The reason is that anticoagulants have been are drugs that are administered to prevent blood from clotting, especially in high-risk patients such as stroke or heart attack patients. If a physician fails to hold pressure on the catheter site for long, there is the risk of the patient over bleeding, which may lead to anemia or death.