22.3.2  When to stop IV infusion

Look for any swelling around the venipuncture site compared with the other hand (or arm), as this may signal that the cannula has moved and the fluid is running into the soft tissue instead of into the vein. If you see swelling, loosen the plaster and remove the IV cannula. Choose a new venipuncture site and use a new sterile IV cannula to enter a new vein and reconnect the IV fluid bag.

IV fluid therapy is stopped when the woman does not need additional fluid any more, or when the venipuncture site has developed an infection (the skin around the site will be red and will feel painful to the patient if you touch it). Sometimes patients may be given too much IV fluid in a short time and this may put stress on the heart because the blood volume has become too large. Fluid can also get into the lungs and in such cases the patient will have difficulty breathing, cough and sometimes become confused. This is not likely to happen while the patient is with you because you will refer her immediately after you started the IV infusion. But in case you encounter this situation, stop the infusion and refer the woman to the next higher facility immediately for further treatment.

You can stop the infusion by closing the roller clamp so no more fluid runs down the tube. Leave the cannula in place for someone at the health facility to remove under sterile conditions.

• To stop an infusion you need sterile or very clean gloves, a clean dry swab, an antiseptic wipe or swab soaked in alcohol, and a new plaster.

Explain what you will be doing to the patient, put on your gloves and turn the roller clamp to the ‘off’ position. Check that the flow of fluid along the tube has stopped. Remove the plaster or other stabilising material over the cannula while holding the cannula in place with your other gloved hand. With a clean dry swab held over the venipuncture site, withdraw the cannula and apply pressure with your fingers to the site for a minute or two. Then swab the site with antiseptic or alcohol to remove any germs that may be near the puncture hole. When the skin is dry, cover the site with a plaster if you have one.

Always make sure the cannula is intact and dispose of it safely in a puncture-proof container.