An IV push refers to a bolus — a dosage of medication and limited fluid — administered intravenously (IV), relatively quickly and during a single administration session. The technique usually utilizes an existing heparin lock or an ongoing IV fluid line, if the medication is compatible with the larger IV system fluid and contents. The IV cannula must be confirmed as safely within the lumen of the vein to avoid delivery of the medication to the surrounding tissues. In addition to this precaution, the correct medication, dosage and delivery order must be confirmed to ensure patient safety. Medical advantages of administering a drug via IV push include a greater systemic concentration of the drug sooner than provided by other delivery routes, administration of a drug when patients cannot take anything by mouth, and reduction of the number and discomfort of intramuscular (IM) injection sites.
Emergency situations are an excellent example of the advantages of administering a medication by push. Effective systemic drug concentrations are reached much more quickly by pushing the IV than most other routes of administration. Faster systemic drug concentration times allow the medication to begin working sooner. This is an important consideration whether the drug is necessary to help restart a heartbeat in a cardiac code, to quickly get antibiotic concentrations up to therapeutic level during a massive infection, or to rapidly relieve a patient’s pain. For instance, pain medication administered by IV push can begin to relieve a patient’s pain within moments, much faster than the 20 to 30 minutes needed for medications taken by mouth to become effective.
IV push medication administration is also helpful when a patient is unable to take medications by mouth — as in preoperative situations or when the patient is unconscious — or when a patient is experiencing vomiting or nausea that precludes drug absorption via the gastrointestinal (GI) tract. Most anti-emetics, or anti-nausea medications, administered in the hospital are administered by push. In some situations, medications that can be administered by IV or by IV push can also be administered intramuscularly (IM). IV or IV push administration of these medications prevents the patient from experiencing the pain or discomfort of an IM “shot,” particularly when multiple administrations of the drug may be necessary.
Finally, many patients with serious cardiovascular, renal or hepatic disorders must have their fluid balances carefully monitored. Administering their medications by pushing the IV, as opposed to a standard IV and dilution within a much larger amount of fluid, helps to limit fluid intake and minimize complications.