Administering Intravenous Pushes

Posted On: July 7, 2023

Recently the matter of administering substances such as glutathione as an IV push, and whether this means of administration is authorized by the College, has come to our attention.

After a review of the General Regulation, the Standard of Practice for Compounding, and the Sterile Compounding of Injectables Guideline through the lens of administering substances via IV push, and a discussion with our legal counsel, the following information is being provided based on the College’s interpretation of these documents.

The General Regulation and the Standard of Practice for Compounding state that when a Registrant compounds a product for the purpose of administering it by intravenous injection, they must ensure that it is performed in an aseptic preparation area using aseptic techniques to minimize the risk of contamination.

When a substance is prepared for intravenous administration, including compounding an IV bag or drawing a substance from a vial into a syringe, the Sterile Compounding of Injectables Guideline says that it should be done under a laminar air flow hood. This is considered to be using aseptic technique in an aseptic preparation area.

Once a substance, or combination of substances, has been aseptically compounded and prepared for injection, it can then be administered to the patient as an initial IV bag, as an IV push through a y-port or as a piggyback IV bag. Using the piggyback method, once the infusion of the initial IV bag has been completed, a second bag (which has its own line) is then administered through connection to a y-port, or if a y-port is not in place, the port used for the initial IV bag. All administrations must be done using aseptic technique to minimize the risk of contamination.

The College understands that many of the educational programs are teaching and recommending the use of the piggyback method over the IV push method in order to minimize the number of IV insertions for the patient and to better regulate the rate of administration of the substance(s); however, Registrants authorized to administer IVIT are expected to use their clinical knowledge, skill and judgement to determine the method that is most appropriate for each patient.

Remember that for all assessments and treatments (not just those related to IVIT) that are within the scope of practice of the profession, you must have acquired the appropriate training and have the necessary skills to ensure that you are providing naturopathic care safely, competently, and ethically.

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