Intravenous (IV) infusions

Most children will have an intravenous (IV) infusion at some point in hospital. We think it is helpful to explain what an infusion is and what it involves, so it is less scary for your child. This page from Great Ormond Street Hospital (GOSH) describes how infusions are used at GOSH, how they are inserted and what to expect when your child has one.An intravenous (IV) infusion is a way of delivering fluid or medicine directly into your child’s bloodstream. This enables the fluid or medicine to get into your child’s system much quicker than taking it by mouth. We use an infusion when a child cannot swallow medicine by mouth or it is better to give it into the bloodstream.

An IV infusion consists of various bits of equipment joined together. The first bit is a cannula (thin, plastic tube) which is put into a vein, usually in their hand or arm. The cannula is then connected to a longer, wider tube which, in turn, is joined to a bag containing the fluid or medicine.

This bag is attached to a machine, which helps to make sure the correct amount of fluid or medicine is given. The machine and bag are hung on a drip stand on wheels so that gravity helps the fluid or medicine.

The first stage is to insert a cannula into a vein.

Most children and young people at GOSH have local anaesthetic cream put on their skin before a cannula is inserted. This takes up to an hour to make the skin numb and is then wiped off.

Alternatively, some children prefer a cold spray, which only takes a few seconds to work but wears off quickly too.

The next stage is to find the right vein to use – usually a vein in the wrist or back of the hand. The nurse will usually put a tight band (tourniquet) around the arm so that the veins stand out better.

They will feel the back of your child’s hand or lower arm to find the best vein and clean the skin over it with an alcohol wipe. They will quickly insert a needle into the vein – this contains the cannula – and remove the needle, leaving the cannula in the vein.

The nurse will usually give the cannula a quick flush of saline (salt water) solution to check it is in the right place and prepare it for the drip. They will make the cannula secure with a see-through dressing and medical sticky tape, before connecting the cannula to a longer, wider piece of tubing called a ‘giving set’. This has a plastic spike on the end so it can be connected to an IV bag.

Finally, the nurse will secure the cannula on your child’s arm or wrist with a splint and bandage – this will stop the cannula being dislodged.

The nurse will connect the cannula to the giving set, thread the longer, wider tube through an IV pump and program the flow rate. The fluid will drip regularly into the drip chamber, through the machine and into your child’s bloodstream.

IV pumps have lots of alarms to tell your nurse about any problems or that the fluid or medicine has all been delivered. The nurse will be listening out for alarms so do not try to turn them off.

Sometimes the medicine can leak out of the vein (extravasation), which can be harmful, depending on the medicine that has leaked. If your child complains of pain or stinging near the cannula, or you notice any redness to the area and the surrounding area, tell the nurse immediately.

All infusions are connected in the same way using the spike and programmed into the IV pump.

When your child no longer needs any IV infusions and the cannula isn’t needed anymore, the nurse will disconnect the tubing from the cannula and throw away the IV bag and giving set.

They will remove the see-through dressing and medical sticky tape, then press down on the vein with gauze or cotton wool while they pull out the cannula. They will tape the gauze or cotton wool in place – you should leave this in place for 30 minutes or so.