Intravenous rehydration is the process by which sterile water solutions
containing small amounts of salt or sugar are injected into the body
through a tube attached to a needle which is inserted into a vein.
Intravenous rehydration is used to restore the fluid and electrolyte
balance of the body due to illness, surgery, or accident. Electrolytes are
salts (sodium, potassium, chloride, calcium, magnesium, phosphate,
sulfate, and bicarbonate) that become ions when mixed with fluids in the
body and blood and have the ability to conduct electricity. The body uses
electrolytes to carry electrical impulses from cell to cell. Moderate to
can interfere with the body's normal functioning. Restoration of
fluids and electrolytes through intravenous means is the swiftest means to
achieve fluid balance.
can cause a child to become dehydrated fairly quickly. Infants and
children are especially vulnerable to dehydration. Athletes who have
over-exerted themselves in hot weather may also require rehydration with
IV (intravenous) fluids. An IV for rehydration can be in place for several
hours to several days and is generally used if a patient cannot drink
Basic IV solutions are made of sterile water with small amounts of sodium
(an ingredient in table salt) or dextrose (sugar) supplied in bottles or
thick plastic bags that can hang on a stand mounted next to the
patient's bed. Additional mineral salts such as potassium and
, or medications can be added to the IV solution by injecting them into
the bottle or bag with a needle or injected directly into the IV line.
Patients receiving IV therapy need to be monitored to ensure that the IV
solutions are providing the correct amounts of fluids and
needed. People with kidney and heart disease are at increased risk for
, so they must be carefully monitored when receiving IV therapy.
A child receiving fluids through an intravenous (IV) bag.
(© Tom Stewart/Corbis.)
The doctor orders the IV solution and any additional nutrients or
medications to be added to it. The doctor also specifies the rate at which
the IV will dispense the solution.
The IV solutions are prepared under the supervision of a pharmaceutical
company, using sanitary techniques that prevent bacterial contamination,
and come prepackaged. Additions to the IV solutions are supervised by a
doctor or nurse. Just like a prescription, the IV is clearly labeled to
show its contents and the amounts of any additives.
The skin around the area where the needle for the IV catheter is inserted
is cleaned and disinfected. Once the IV catheter is in place, it is taped
to the skin to prevent it from being dislodged. The IV line is then
attached to the IV catheter. Any other IV lines can be added to the IV
Patients need to take fluids by mouth before an IV solution is
discontinued. After the IV needle is removed, the site should be inspected
for any signs of bleeding or infection.
There is a small risk of infection at the injection site that is usually
treated topically. It is also possible that the IV solution may not
provide all of the nutrients needed, leading to a deficiency or an
imbalance, which would need to be corrected.
If the needle becomes dislodged, the solution can flow into tissues around
the injection site rather than into the vein. This is called
extravasation, or infiltration, and occurs in about half of pediatric IVs.
In most cases, the patient reports a burning or stinging sensation at the
site of the needle or IV catheter, especially when new IV fluids are
started or the speed of the IV drip is increased. The tissues usually
swell and become discolored, looking like a bruise. Usually, the IV
catheter is removed and reinserted at another site.
If an IV has been in place for a long time or the child has had a medical
condition that weakens the veins, the
child may experience vein collapse. This occurs when the vein is not able
to receive anymore intravenous fluid and forces the IV solution into the
surrounding tissues. It can also occur if a thrombosis, or blood clot,
forms in the vein at the IV catheter site.
A collapsed vein feels and looks much like a dislodged IV catheter. This
can sometimes happen when the nurse has inserted a needle or IV catheter
that is too big for the size of the vein. This isn't a misjudgement
on the nurse's part. Standard sized needles are used and only
rarely are extremely thin needles necessary. They may be needed in adult
patients as well as children. If vein collapse occurs, the IV catheter
should be removed and reinserted into a different vein, usually in another
part of the body. For example, if a vein in the left arm collapses, the
nurse can put a new IV catheter into the right arm.
Treatment for an extravasation or a collapsed vein are similar. A warm
compress is usually applied to the injection site to reduce swelling. If
there is sufficient injury at the injection site, general wound care is
done to prevent infection and speed healing.
—A sugar solution used in intravenous drips.
—Salts and minerals that produce electrically charged particles
(ions) in body fluids. Common human electrolytes are sodium chloride,
potassium, calcium, and sodium bicarbonate. Electrolytes control the
fluid balance of the body and are important in muscle contraction,
energy generation, and almost all major biochemical reactions in the
—To pass from a blood vessel into the surrounding tissue.
—An element; sodium is the most common electrolyte found in
animal blood serum.
—The formation of a blood clot in a vein or artery that may
obstruct local blood flow or may dislodge, travel downstream, and
obstruct blood flow at a remote location. The clot or thrombus may lead
to infarction, or death of tissue, due to a blocked blood supply.
Intravenous Therapy for Nurses.
Albany, NY: Delmar Publishers, 1998.
"Water, Electrolyte, Mineral, and Acid-Base Metabolism." In
The Merck Manual.
16th ed. Rahway, NJ: Merck, 1992.
Atherly-John Y. C., et al. "A Randomized Trial of Oral vs
Intravenous Rehydration in a Pediatric Emergency Department."
Archives of Pediatric Adolescent Medicine.
156 (December 2002): 1240–3.
Camp-Sorrell, D. "Developing Extravasation Protocols and Monitoring
Journal of Intravenous Nursing.
21, no. 4 (1998): 232-239.
Castellani, J. W., et al. "Intravenous vs. Oral Rehydration:
Effects on Subsequent Exercise-Heat Stress."
Journal of Applied Physiology
82 (Mar. 1997): 799–806.
Montgomery, L. A., Hanrahan, K. and K. Kottman. "Guideline for IV
Infiltrations in Pediatric Patients."
25, no. 2 (1999): 167–180.