THERAPEUTIC PROCEDURES - Medicine for Mountaineering and Other Wilderness Activities - page 534

9. The contents of the syringe should be injected slowly to minimize discomfort, but the
needle should be withdrawn quickly.
Intravenous Medications
Intravenous drug administration is required in a few medical emergencies, may be the
only effective way to administer drugs to individuals who are in shock, and is the most
effective method to treat some severe infections because higher blood concentrations of a
therapeutic agent can be attained. In addition, a more constant blood concentration of the
drug can be maintained without the swings associated with intermittent intramuscular or
oral administration.
However, intravenous injections may be hazardous because high drug concentrations in
the blood can develop quite rapidly. If some medications are injected too rapidly, severe
complications canresult.Likeintramuscular injections,onceanagenthasbeeninjectedin-
travenously it cannot be recovered. If the person has an allergic reaction to the drug, little
can be done to reverse the process and it must be treated. Such injections must be given
only when necessary and specified rates of injection must be closely observed.
The technique for administering intravenous medications over a long period of time is
the same as intravenous fluid administration. Intravenous antibiotics are usually admin-
istered by injecting the antibiotic directly into a bag of intravenous fluids. Drugs also may
be injected through a port on the tubing.
If the person is in shock and veins in the forearm cannot be identified, or if intravenous
fluids and the equipment to administer them are not available, intermittent injections such
as the periodic injections of morphine to provide analgesia for a person in shock, can be
given in the large veins located in the fold of the arm at the elbow or those on the back of
the hand.
Preparationoftheinjectionsiteshouldbethesameasforintramuscularinjections.After
the needle has been inserted into a vein, a small amount of blood should be withdrawn to
dilutethedrugandmakecertaintheneedleisintheproperlocation.Subsequently,thedrug
should be injected slowly, but continuously, over a period of two to three minutes.
Intravenous Fluid Therapy
Intravenous fluid therapy is required to replace normal and abnormal fluid losses for
individuals who are not able to take fluids orally, to administer fluids following a severe
hemorrhage, and for the intravenous administration of some medications.
Currently, plastic catheters are used in most U.S. medical centers for the administration
of intravenous fluids because they rarely puncture the vein walls after they have been in-
serted, as do sharp needle tips, and they do not become dislodged as easily.