What Is IV Bolus?

When choosing a medication administration method, clinicians may often choose the IV bolus route as an effective way to alleviate pain or dehydration in less than 30 minutes. But what is IV bolus therapy exactly, and what are its use cases?

IV bolus is a medical technique that delivers necessary fluid to the body directly through the bloodstream. It differs from regular IV drip in that it’s quicker and may offer faster effects.

Below, learn how IV bolus works step-by-step and follow the safety tips and guides for dosage calculation and drug compatibility.

Source: shutterstock.com / Photo Contributor: SeventyFour

What Is IV Bolus?

In medical terms, bolus refers to a single large dose of medication given over a short period. From here, we can describe the IV bolus definition, which is a method of intravenous therapy. IV bolus can be used in emergency and non-emergency situations.

The main characteristic of an IV bolus is that it takes between 15 and 30 minutes, making it quicker than an IV drip and slower than an IV push. It uses an open fluid line and a fluid bag to let the liquid pass through faster. Both are connected to a syringe that delivers the medications straight to the bloodstream. 

Because the nurse administers medication in a larger quantity at once, the dosage calculation is critical for ensuring the patient’s safety and the drug’s effectiveness.

There are some advantages and disadvantages of IV bolus administration. For example, IV bolus therapy can be titrated or adjusted to the specific patient’s requirements, delivering a precise drug quantity. On the other hand, it involves rapid injection, making it difficult to prevent negative outcomes due to inaccurate dosage.

Indications for IV Bolus Administration

Now that we’ve specified the IV bolus meaning let’s discuss the use of this technique. An IV bolus is most frequently administered for diabetes patients who require insulin but also finds other uses for quick relief from symptoms related to hangovers, dehydration, vitamin deficiency, or similar conditions. When used to treat and manage dehydration, IV bolus may be a good option as this therapy type allows the fluids to enter the body in less than 20 minutes. Dehydration often occurs when losing or not drinking enough fluids. Dehydration may also occur after vomiting and diarrhea or from spending too much time in the heat.

Patients may receive IV bolus therapy at the hospital or opt for effective mobile IV therapy in Arizona, which involves the nurse coming to their house and helping them set up the IV. This is a preferred option by patients who want to receive IV therapy in their space of comfort.

Considerations for IV bolus in different patient populations

All patient populations can receive IV bolus therapy. However, poor fluid management is always a risk and can result from:

• 
  Lack of knowledge of the basic principles of fluid balance
  
• 
  Inability to analyze fluid balance documentation and draw conclusions (such as the misreading of lab results)
  
• 
  Lack of involvement of senior clinicians in the process of fluid management and administration.
  

To prevent the adverse effects of improper IV bolus dosage or prescription of the wrong medication, clinicians tailor IV bolus therapies to patients’ age requirements, taking into consideration:

• 
  The type of fluid and its amount
  
• 
  The duration of IV bolus therapy
  
• 
  The weight of the patient
  
• 
  The underlying conditions of the patient, and other metrics.
  

When administered effectively, IV bolus therapy positively impacts the patient, addressing nutrient deficiencies and ensuring rehydration and stable vital signs.

Critical care settings where IV bolus is commonly used

IV bolus therapy for patients in intensive care can be used in the case of:

• 
  Severe burns
  
• 
  Broken bones
  
• 
  Heart conditions
  
• 
  Respiratory and organ failure
  
• 
  Life-threatening illnesses in general.
  

IV Bolus Administration Procedure

When administering IV bolus therapy, nurses follow the six rights of medication administration:

• 
  Right medication
  
• 
  Right dose
  
• 
  Right patient
  
• 
  Right route
  
• 
  Right time 
  
• 
  Right documentation
  

Here are the steps involved in IV bolus administration using the three-way tap method:

1. 
   Open the fluid bag
   
2. 
   Clamp the giving set, remove the lid, and attach it to the fluid bag
   
3. 
   Hand the fluid bag
   
4. 
   Squeeze the drip chamber until it’s halfway full
   
5. 
   Attach the giving set and syringe to the three-way tap, allowing the fluid to pass freely from the bag into the syringe
   
6. 
   Open all of the clamps
   
7. 
   Let the syringe fill with liquid
   
8. 
   Release the excess air from the syringe through the three-way tap
   
9. 
   Attach the three-way tap to the cannula
   
10. 
     Unclamp the cannula and administer the fluid to the patient
    

All equipment used in the IV bolus therapy must be disinfected and sterilized according to CDC guidelines.

Source: shutterstock.com / Photo Contributor: SeventyFour

Dosage Calculation and Drug Compatibility

What is IV bolus dosage calculation? It refers to the steps taken to ensure the correct drug product dosage. 

A medical professional may use a calculator for greater precision to calculate the required dosage and avoid errors. A drip rate chart comes in handy since it presents precalculated dosages used as general guidance. 

To prevent administering the wrong dose, the clinician may then use a drip chamber to calculate the number of drops required for 1 mL of the fluid. 

The fluid amount equation for a single dose is:

(Drug ordered / Drug Available) x total mL in vial =  mL

Finally, the clinician needs to take into account other drugs that the patient is taking and determine their compatibility and possible side effects of mixing different drugs. Keeping a record of the patient’s medication quantities thus far will eliminate adverse reactions.

Conclusion

What is IV bolus medication administration? It refers to the intravenous way of delivering drugs to a patient for near-immediate effects. The dosage administered using this method is larger than when using an IV push and can last from 15-30 minutes. 

Diabetes patients make the most use of IV bolus; however, the critical care department also utilizes this technique in cases of severe burns, organ failure, and other life-threatening situations.

When administering IV bolus, it’s best to leave it to the professionals as they know the right dosage instructions and safety protocols, preventing negative effects and ensuring precision and accuracy.