Quiz: IV Administration Rates: Push Versus Bolus Versus Slow

Melinda J. Anderson, PharmD, FSVHP, RVT, Purdue University

ArticleQuizzesLast Updated April 20242 min readPeer Reviewed
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Intravenous injections can be administered as a single volume rapidly (within 1 minute; ie, rapid push) or slowly (within 2-5 minutes; ie, slow push) or as a CRI over time.1 The terms IV push and IV bolus indicate medication should be given rapidly to provide desired effects. Although these terms are commonly used interchangeably, IV push typically describes a small volume given as quickly as possible, and IV bolus typically describes a large volume given steadily over 5 to 30 minutes, depending on the drug and volume to be administered. IV push and IV bolus are not consistently differentiated in the literature. Medication slowly injected or dripped into a vein over 30 minutes or more is considered an IV infusion or IV CRI.

It is critical to understand the benefits and consequences of administering a medication too rapidly or too slowly prior to administration. The method by which IV medication is administered depends on a variety of factors that should be carefully considered to maximize therapeutic and patient outcomes. For example, consideration should be given to patient acuity potentially requiring medication to reach systemic circulation as soon as possible compared with a patient requiring consistent analgesia. Patients with fluid restrictions (eg, acute kidney injury, congestive heart failure) are the best candidates for IV push for medications such as IV antibiotics to reduce the risk for fluid overload.

Not all medications can be given as an IV push, and fatal consequences are possible when certain medications are too concentrated or administered too rapidly.