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August 20, 1982

'Bolus' Injections

JAMA. 1982;248(7):831. doi:10.1001/jama.1982.03330070019021

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To the Editor.—  In the medical literature there sometimes appear confusing word usages that may lead to dangerous misconceptions. Such a phrase, really quite abominable, is "intravenous bolus injection." It has invaded the literature, with its users apparently having little concern for its meaning.Both Dorland's Medical Dictionary (ed 26) and Webster's Eighth NewCollegiate Dictionary define bolus as "a rounded mass," and surely the intent of the word is to describe a discrete mass, rather than a discontinuous trickle. It is true that some agents should be injected intravenously as a discrete mass. An example would be the injection of a radiopaque dye to visualize a cardiac chamber. However, most drugs should not be given as a rapidly injected "bolus." Indeed, they should be given slowly, in the manner of an intravenous trickle.House officers are often confused by the meaning of a "bolus injection," and sometimes inappropriately hasten