Checklist
| Preparation | Wash – Name – Explain | |
| Check for allergies | ||
| Check cannula | ||
| Check fluid prescription | ||
| Clean preparation surface | ||
|
Gather equipment (See explanation if pre-filled flush unavailable) |
Clean equipment tray | |
| Wash hands | ||
| Cannula cleaning equipment | ||
| Intravenous fluid | ||
| Intravenous giving set | ||
| 0.9% NaCl flush | ||
| Safe sharps disposal | ||
| Prime giving set | Return to patient | |
| Wash hands and put on gloves | ||
| Hang up the intravenous fluid | ||
| Attach giving set to fluid bag | ||
| Fill drip chamber halfway | ||
| Run fluid through line and expel all air | ||
| Clamp the giving set | ||
| Dispose of 1st pair of gloves | ||
| Set up infusion | Wash hands and put on 2nd pair of gloves | |
| Clean cannula port site | ||
| Flush cannula | ||
| Attach giving set to cannula | ||
| Set infusion rate | ||
| Finishing | Dispose of all waste appropriately | |
| Wash hands | ||
| Sign fluid prescription |
Explanation
Preparation
Wash, name, explain:
- Wash your hands
- Introduce yourself by name and role
- Check the patient’s name and date of birth
- Explain the task and get consent
- Check whether the patient has any known allergies, e.g., to plasters
“Hello, I’m one of the doctors. I’ve been asked to give you some intravenous fluid. This will involve attaching a drip to the cannula in your arm. It should not be painful. You can ask me to stop at any time. Would that be okay?”
It is important to check that the patient has a cannula, and that it is clean and the insertion site looks healthy.
Check the intravenous fluid prescription, ensuring the patient’s details match those of the patient on whom you intend to perform the procedure. Also check the type of fluid which has been prescribed, the infusion rate and the presence of the prescriber’s signature. Take the prescription with you to gather your equipment for reference.
Position the patient appropriately for the procedure. For intravenous fluid infusion, ensure the patient is sitting in a comfortable position and that you can easily access the cannula site. You may wish to place a pillow under the patient’s arm for support.
Clean your preparation space, typically a clinical trolley, using appropriate surface cleaning agents.
Gather Equipment
Clean an equipment tray and place it on your preparation surface. Wash your hands again after cleaning surfaces.
Gather the following equipment and place it in your clean tray, ensuring that key parts remain protected:
- Cannula cleaning wipe – usually alcohol-based
- Intravenous fluid – check the fluid against the prescription as well as the expiry date. This may need countersigning by a colleague.
- Intravenous giving set
- 0.9% NaCl flush – if no pre-filled flush is available, please see instructions below for preparing a flush
- Safe sharps disposal e.g., sharps bin
Follow the steps below if you need to prepare your own 0.9% NaCl flush:
- Gather equipment: 10ml syringe, drawing-up needle, 21 or 23G needle, 0.9% NaCl ampoule
- Check the expiry date of the NaCl
- Attach drawing–up needle to syringe, ensuring that you do not touch the key parts
- Draw up 10ml of NaCl into syringe
- Attach 21 or 23G needle to protect key part of the syringe
- Expel any air bubbles
Prime Giving Set
Return to the patient, wash your hands, and confirm that they are still willing to proceed. Put on your first pair of gloves.
Hang the intravenous fluid bag on a drip stand. Remove the cover from the port on the fluid bag. Unsheathe the spike on the giving set and attach it to the fluid bag via the port. Both the port and the spike are key parts, so ensure they remain untouched.
Squeeze the drip chamber several times until it is half–filled with fluid. Using the roller wheel, unclamp the intravenous giving set and slowly run fluid through the entire line until drops are expelled from the distal end. Ensure that there are no air bubbles in the line. Clamp the giving set.
Dispose of the first pair of gloves and wash your hands.
Set Up Infusion
Wash your hands and put on your second pair of gloves.
Remove the cap from the patient’s cannula and clean the port for 30 seconds then let the site air dry for a further 30 seconds. Flush the cannula with 0.9% saline and ensure that the patient does not experience any pain, and that the site does not appear swollen or red. These are indications that the cannula has tissued and should not be used for fluid infusion.
Remove the cover from the end of the giving set and attach it to the patient’s cannula, ensuring that you do not touch the clean cannula port or the sterile end of the giving set.
Start the infusion, making sure to calculate the correct infusion rate. This can be done either by calculating the drip rate or by using a volumetric infusion pump.
Finishing
Confirm that the patient is feeling well. Ensure that you sign the fluid prescription to indicate that the infusion has been given, and document the infusion start time.
Dispose of all waste appropriately and clean your tray and trolley. Wash your hands.
Last updated Mar 2025
Head to members.zerotofinals.com for practice OSCE stations, including an interactive checklist, specific cases and clinical findings.
