A Brief History Of IV Infusion Therapy, From The Middle Ages To Today

Although intravenous therapy is an extremely common sight in hospitals and healthcare facilities across
the nation, most of us don't give a lot of thought into the history of the IV. While IV infusion therapy is
relatively new, the concept behind it can be traced back centuries. In today's post, we'll take a brief look
at the history of IV infusion therapy and how we've arrived where we are today.

The Middle Ages

IV infusion pumps themselves aren't a Medieval invention, but the idea behind these kinds of
treatments emerged during the Middle Ages. At the time, experiments were done in an effort to
transfuse blood between humans and animals. Poor results (plus an official decree from the Vatican)
eventually put a stop to these experiments. There were some instances of human-to-human
transfusions during this time period as well, but they were not very successful.

Sir Christopher Wren created the first successful infusion device during his lifetime (1632-1723). The
device, made from a pig's bladder and a writing quill, wasn't very durable -- but it worked. It allowed him
to pump outside substances into the bloodstream of a dog. (Fun fact: Wren also made improvements to
the microscope.) Although the device he created was a challenge to secure, it did pave the way for
future creations, like the IV pumps we use today.

The 19th Century

Modern medicine has really come a long way in a short time. It really wasn't until the early-to-mid-1800s
that injections and transfusions started to be readily used to improve patient health. During the 1930s,
Dr. Thomas Latta found that salt water, injected into the bloodstream, could help fight cholera. A couple
of years later, Dr. James Blundell used transfusions during postpartum hemorrhages and observed that
the speed of infusion had a direct impact on its success. Blundell later created a device that monitored
an infusion's speed of flow.

During the early part of the century, IV infusions were housed in an open container which was covered
with gauze in an effort to prevent contamination. It was a method that was mostly effective, but it didn't
always work. In the 1930s, infusions were kept in a vacuum-sealed glass bottle. A couple of decades
later, IVs switched over to the plastic bag we use today. Interestingly, it wasn't until the 1940s that a
nurse was allowed to administer IV therapy (until that time, only doctors were permitted to do so).
These days, nurses are the ones who typically handle IV therapy for patients.
In the 1960s, IV infusion pumps became a ubiquitous sight in hospitals all across the country. This was
also during the time when Dr. John Myers started injecting patients with what he called a “cocktail” of
vitamins and minerals. His exact formula was lost upon his death in the 1980s, but experts came up with
a modified version that's pretty close. The cocktail includes vitamins B and C, magnesium sulphate,
calcium gluconate, and selenium to manage conditions ranging from allergies and asthma, to heart
disease and fibromyalgia. This showed that IV therapy isn't just for blood transfusions; it can help
patients receive valuable nutrients, too.

Circa Now

As medical professionals and patients will know, IV therapy is a regular part of healthcare in the modern
age. No longer a controversial treatment, it's used on an everyday basis for countless people all across
the nation. It's used to both improve and save lives in numerous ways. But even though it's widely
accepted, it's always being improved upon. Smart infusion pumps, for example, help to improve patient
control while not compromising on quality. Although those early experiments may not have seemed like
milestones, they were truly the building blocks of treatments on which we rely today.

2) A blood transfusion is a procedure that restores blood to the body.

A healthcare professional will pass blood through a rubber tube into a vein using a needle or thin tube.

The sections below will cover the different types of blood transfusion procedures available, as well as
the different types of blood

Why are blood transfusions necessary?

Blood transfusions are necessary when the body lacks enough blood to function properly. For example,
a person may need a blood transfusion if they have sustained a severe injury or if they have lost blood
during surgery.

Some people need blood transfusions for certain conditions and disorders, including:

 Anemia: This occurs when a person’s blood does not have enough red blood cells. It can develop
for a number of reasons, such as if a person does not have enough iron in their body. This is
known as iron deficiency anemia.
 Hemophilia: This is a bleeding disorder wherein the blood is unable to clot properly.

 Cancer: This occurs when cells in the body divide and spread to the surrounding tissues.

 Sickle cell disease: This is a group of red blood cell disorders that change the shape of red blood
cells.

 Kidney disease: This occurs when the kidneys are damaged.

 Liver disease: This occurs when the liver stops functioning properly

3) Verify the physician’s written order and make a treatment card according to hospital policy
 Observe the 10 Rs when preparing and administering any blood or blood components
 Explain the procedure/rationale for giving blood transfusion to reassure patient and significant
others and secure consent. Get patient histories regarding previous transfusion.
 Explain the importance of the benefits on Voluntary Blood Donation (RA 7719- National Blood
Service Act of 1994).
 Request prescribed blood/blood components from blood bank to include blood typing and cross
matching and blood result of transmissible Disease.
 Using a clean lined tray, get compatible blood from hospital blood bank.
 Wrap blood bag with clean towel and keep it at room temperature.
 Have a doctor and a nurse assess patient’s condition. Countercheck the compatible blood to be
transfused against the crossmatching sheet noting the ABO grouping and RH, serial number of
each blood unit, and expiry date with the blood bag label and other laboratory blood exams as
required before transfusion.
 Get the baseline vital signs- BP, RR, and Temperature before transfusion. Refer to MD
accordingly.
 Give pre-meds 30 minutes before transfusion as prescribed.
 Do hand hygiene before and after the procedure
 Prepare equipment needed for BT (IV injection tray, compatible BT set, IV catheter/ needle G
19/19, plaster, torniquet, blood, blood components to be transfused, Plain NSS 500cc, IV set,
needle gauge 18 (only if needed), IV hook, gloves, sterile 2×2 gauze or transplant dressing, etc.
 If main IVf is with dextrose 5% initiate an IV line with appropriate IV catheter with Plain NSS on
another site, anchor catheter properly and regulate IV drops.
 Open compatible blood set aseptically and close the roller clamp. Spike blood bag carefully; fill
the drip chamber at least half full; prime tubing and remove air bubbles (if any). Use needle g.18
or 19 for side drip (for adults) or g.22 for pedia (if blood is given to the Y-injection port, the
gauge of the needle is disregarded).
 Disinfect the Y-injection port of IV tubing (Plain NSS) and insert the needle, from BT
administration ser and secure with adhesive tape.
 Close the roller clamp of IV fluid of Plain NSS and regulate to KVO while transfusion is going on.
 Transfuse the blood via the injection port and regulate at 10-15gtts/min initially for the first 15
minutes of transfusion and refer immediately to the MD for any adverse reaction.
 Observe/Assess patient on an on-going basis for any untoward signs and symptoms such as
flushed skin, chills, elevated temperature, itchiness, urticaria, and dyspnea. If any of these
 symptoms occur, stop the transfusion, open the IV line with Plain NSS and regulate accordingly,
and report to the doctor immediately.
 Swirl the bag gently from time to time to mix the solid with the plasma N.B one B.T set should
be used for 1-2 units of blood.
 When blood is consumed, close the roller clamp, of BT, and disconnect from IV lines then
regulate the IVF of plain NSS as prescribed.
 Continue to observe and monitor patient post transfusion, for delayed reaction could still occur.
 Re-check Hgb and Hct, bleeding time, serial platelet count within specified hours as prescribed
and/or per institution’s policy.
 Discard blood bag and BT set and sharps according to Health Care Waste Management
(DOH/DENR).
 Fill-out adverse reaction sheet as per institutional policy.
 Remind the doctor about the administration of Calcium Gluconate if patient has several units of
blood transfusion (3-5 more units of blood).
4) Acute Transfusion Reactions
 Mild  allergic: Attributed to hypersensitivity to a foreign protein in the donor product.
 Anaphylactic: Similar to a mild allergic reaction, however resulting in a more severe reaction.
Sometimes this can occur in a patient with IgA deficiency who makes alloantibodies against IgA
and then receives blood products containing IgA.
 Febrile non-hemolytic: Generally thought to be caused by cytokines released from blood donor
leukocytes (white blood cells).
 Septic: Caused by bacteria or bacterial byproducts (such as endotoxin) which may contaminate
blood.
 Acute hemolytic transfusion reactions: Can result in intravascular or extravascular hemolysis,
depending on the specific etiology (cause). Immune-mediated reactions are often a result of
recipient antibodies present to blood donor antigens. Non-immune reactions are possible, and
occur when red blood cells are damaged before transfusion (e.g., by heat or incorrect osmotic
conditions).
 Transfusion-associated circulatory overload (TACO): Occurs when the volume of the transfused
component causes hypervolemia (volume overload).
 Transfusion-related acute lung injury: Acute lung injury is due to antibodies in the donor product
(human leukocyte antigen or human neutrophil antigen) reacting with antigens in the recipient.
The recipient’s immune system responds and causes the release of mediators that lead to
pulmonary edema. Possibly contributing to this are clinical conditions that predispose the
patient including infection, recent surgery, or inflammation.
Delayed Transfusion Reactions
 Delayed hemolytic transfusion reaction: Typically caused by an anamnestic response to a foreign
antigen that the patient was previously exposed to (generally by prior transfusion or pregnancy).
 Transfusion-associated graft-versus-host disease: Results from engraftment of donor
lymphocytes (commonly found in cellular blood products) into an immunocompromised
recipient’s bone marrow. The donor lymphocytes recognize the patient as foreign and react
against the recipient’s body. The patient’s immune system is unable to clear the foreign
lymphocytes. This is rare but often fatal.