Labels on IV bags in hospitals?

Here in the UK it'd be easier to read the patient's notes, handily kept at the foot of their bed.

Is this for the US?

If so, it depends on the drug. Sometimes the IV is kept open with a bag of saline and that’s hanging from the pole all the time. When a periodic drug is required, a smaller bag is also hung for the time it takes that drug to run through (IV antibiotics can be done this way). Sometimes the patient has a heparin lock, which means the IV catheter is in the vein but there’s no bag attached. A bit of heparin is inserted to keep the blood from clotting off in the tubing and when an IV drug needs to be infused, it’s done right there with a syringe or a small bag, and then the hep lock is loaded with more heparin until next time.

If there is some sort of drug that needs to be given all the time and is hung with the saline or ringer’s bag, then yes that drug is labeled.

In most US hospitals the charts are not kept either at the bed side or near the door, they’re at the nurses’ station or on the nursing cart. This is more true since HIPPAA was signed into law.

When is your story set? What drug are you giving your character? What do you need to have happen for the story?

My (Canadian) experience is as Ultragotha says-- there's the basic saline drip bag that's on all the time while the patient is hooked up to the IV machine, then the antibiotics themselves are smaller bags that are hung at the scheduled times. The antibiotic bags always have a label with the patient's name, drug name, and dosage information. Once the bags are empty they are just tossed out, but to keep the pokey part that goes into the bag sterile usually the most recent one hangs there empty until the next dose, so the pokey thing can go direct from the empty bag to the new one. I usually have two different antibiotics and sometimes the nurse hangs them both on the pole before running the first one so she doesn't have to go get the second, though some nurses do bring them one at a time. Sometimes the nurse tosses out the first empty bag before running the second and sometimes she doesn't.

So-- yes, for me anyway a visitor could definitely go up to the pole and look at what's printed on the bags to see what I'm getting. In fact I've had doctors do that when they couldn't remember exactly and didn't have my chart on them. But if there's more than one antibiotic only one might be represented at a time.

I've also never had notes at the end of my bed; in fact they aren't even supposed to let me hold my chart when I'm being taken to do a test in another part of the hospital, even if I can walk they have to get a porter to carry it.

I guess we're more...? something here in the UK. Trusting, careless?

Morphine is often given by IV for severe pain. If a patient is allergic to morphine, dilaudid is next on the list, at least around here (southern US).

It's also common to give anti-nausea drugs by IV, because if someone's going to be sick, pills won't stay down long enough to work. I don't remember the name of what they gave me for nausea, but it was very caustic. After a couple of doses, I developed phlebitis--my veins swelled up and I had red streaks down my arm. It was painful for days afterwards.

inspiredbymusic said:

If someone in the hospital is receiving medications through an IV drip, how is the IV bag labeled? Could someone visiting the patient find out what medications are being administered by reading the label on the IV bag?
Thanks.

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Yes.

Fluids typically don't have any sort of patient information on it. If you're running fluids in the bag will just say, "0.9 Normal saline," "Lactated Ringers" or "5% dextrose and .09 sodium chloride," and then some more details in smaller print.

IV meds vary by institution but common practice in my experience the pharmacy will send up a bag that is labeled with the medication, the amount of fluid and the patient's name. This is one of those situations where safety trumps privacy. So yes, anyone in the room can see the medication. Some antibiotics typically given via infusion include vancomycin, clindamycin, ciprofloxacin and azithromycin.

Typically pain medications aren't given via IV drips. In really acute situations they are hung, but typically the analgesics that we have work well enough that they don't have to be constantly infused. Unless someone is dying, which I have little experience with so I can't really say how it works, if they're in a place where they can have visitors they likely won't have a pain med via continual infusion unless its part of a PCA device.

Where it can be confusing is that a lot of medication are given IV, but they're IV push. Fentanyl, morphine and dilaudid are routinely given IV push. That means that drugs are typically diluted and then administered through an IV port via a syringe.

FWIW, all of my IV drugs have had a label with the drug information and another label with patient name, number and date of birth. All have been checked against a printed list left at my side, again with information printed on it. This includes standard fluids such as a saline drip.

There is too high a possibility of administering the wrong medication for any insurance provider to the clinic or hospital to not require multiple checks on all medications. Emergency medications, such as plasma or a saline drip may not have full labels for patient ID, but they are all still plainly labeled.

Now, what do you nee for your story? Someone to see what a patient is on? And what kind of result?

Jeff

Agree with others that in the US the charts are kept private but the IV bags are labeled and so could be read while hung.

Buffysquirrel said:

Here in the UK it'd be easier to read the patient's notes, handily kept at the foot of their bed.

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This is interesting to me. I've wondered how the US (with HIPAA laws) compares with other countries re: health privacy.

HIPAA privacy rules make sense in some ways but are an extreme pain-in-the-butt in other ways. Cause a lot of grief for families who can't get info on their family members but the records are available for so many other entities - insurance, courts, police, other health providers ... anyone but family it seems.

My experience is UK based so perhaps not relevant, but I've only ever had pain meds administered by either the clicky-button (for morphine) where you have a button to click to get a set dose, and you have to wait until the light comes back on on the button before you can click again, or by syringe driver. This has a needle that goes into the upper arm (and is a pain in the butt, tbh), attached to a big syringe in a holder with a motor that slowly pushes the plunger on the syringe, so you get a steady dose over a long period of time. The driver can be set to certain speeds etc. The one I had (at that point for anti-emetic medication) was actually marked as coming from the palliative care unit of the hospital and the nurse told me it was used for pain meds for people there.

I never had my name on the saline drip, only the antibiotics - at least I think it was written there - they were handwritten labels so it could've said 'chicken soup' for all I could read.

And my notes were also at the foot of the bed. One particularly boring evening on the ward we all got the folders out and compared what had been written about us. Some of it was pretty insulting actually!

Zelenka said:

And my notes were also at the foot of the bed. One particularly boring evening on the ward we all got the folders out and compared what had been written about us. Some of it was pretty insulting actually!

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Isn't it amazing the kinds of things they'll write if they think you'll never read it? As a teenager, I was in a vocational rehabilitation program, where they were trying to help me go to college and find a job, in spite of being disabled. One day, they handed me some paperwork, and somehow my file notes got mixed in accidentally. Of course, I read them. And I was both shocked and insulted at the things the staff psychologist had said about me!

One comment that stood out said I "smiled inappropriately when discussing my health problems." Sure, I gave a half-smile and shrugged during my interview to show that I wasn't going to let chronic pain get the better of me. How is that "inappropriate"?

I brought the papers back at my next appointment and the psychologist was quite displeased. She acted as if I'd stolen them. Needless to say, I soon quit that program.

I wrote a verbose description of what you might see in the rooms, don't even think of using this much detail.

It matters why the patient is in the hospital, because that will determine which floor and hence which Ivs might be hanging.

If the person is there for a disease process , such as GI (gastrointestinal), respiratory, auto-immune, cancer, etc they will be on a general medical or oncology floor or the med/onc unit. You will see a 1 liter bag of Lactated Ringers or 0.9% Sodium Chloride or even Dextrose 5% and NS combo. Some places might have a 4x3 inch white sticker slapped on the bag by the nurse, sometimes crisply, other times haphazardly with a crease in the label because the nurse was in a hurry. In black pen you will see the patient's last name, a date such as 9/15 or 9-15, military time (I.e. 16:30), a number for the rate of the drip, such as 75/hr (it means 75 milliliter per hour), and scrawled initials of the nurse. The label will have other preprinted lines, but a lot of times those are skipped, because they are not as important.

If the person broke a bone from a fall or wreck, or had surgery to remove an appendix or gallbladder, then they will be on the surgical/orthopedic or surg/ortho unit. Same thing, LR or NS hanging, and either a little pump (syringe pump) with a 10 or 20ml syringe in it, attached to the IV pole above the main fluid pump. Refer to MDSchafer's post regarding drugs, but I will add that cefazolin is another common antibiotic for a post surgical patient. These antibiotics usually come in 100ml bags and 250 ml for the vancomycin. This day and age the antibiotic bags will have printed labels. The pharmacist will handwrite an expiration date and initials on the bag. Sometimes the nurse will also, confirming she checked the drug.

Most bag antibiotics are piggybacked into the larger fluid bag. They typically are infused over 30-60 mins, so most likely you will walk in the room and see an IV pump on a pole. At the top of the IV pole, you will see a plastic hook about 6-8 inches long in which your larger maintenance fluid bag is hung on the end of it. The antibiotic bag will be attached to the IV pole above the larger bag; its shorter IV line twisted into the main IV line, but in a port above the pump. Most likely the antibiotic bag will be empty because it was infused several hours ago.

If the person is end of life, then you may see a morphine bag on an IV pump for comfort in their final hours.

The IV lines themselves will usually have a little sticker wrapped around them with date and time hung, date and time expired (72 or 96 hours from hang date) and nurses initials.



I hope this level of detail helps in your research. I did this stuff for 18 years.