Overview

Peripheral IV Access is a fundamental procedure used to establish venous access for administration of medications, fluids, and blood products. It is the most common invasive procedure performed in healthcare.

Peripheral IV access is crucial for fluid resuscitation, medication administration, blood sampling, and emergency care. It provides immediate access for life-saving interventions.

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Indications

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Fluid Administration

Intravenous fluids and medications

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Emergency Access

Rapid venous access

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Blood Sampling

Laboratory testing

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Contrast Administration

Radiological procedures

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Anesthesia

Pre-operative access

Contraindications

Absolute Contraindications

✗ Patient refusal
✗ Active infection at site

Relative Contraindications

✗ Lymphedema
✗ Previous radiation
✗ Thrombophlebitis

📋 Equipment Checklist

Check off items as you gather them:

Pre-procedure Preparation

Preparation includes patient consent, vein assessment, equipment preparation, and sterile technique. All team members should understand their roles.

Step-by-Step Procedure

Step 1: Patient Preparation

Explain procedure, obtain consent, assess veins.

⚠️ Common Mistakes to Avoid:

  • Inadequate consent
  • Poor vein assessment

💡 Pro Tip:

Assess both arms for best vein selection.

Step 2: Vein Selection

Choose appropriate vein, apply tourniquet.

⚠️ Common Mistakes to Avoid:

  • Wrong vein selection
  • Poor tourniquet placement

💡 Pro Tip:

Use non-dominant arm when possible.

Step 3: Skin Preparation

Clean skin with alcohol, allow to dry.

⚠️ Common Mistakes to Avoid:

  • Inadequate cleaning
  • Wet skin

💡 Pro Tip:

Allow alcohol to dry completely.

Step 4: Vein Stabilization

Stabilize vein, insert catheter at 15-30 degree angle.

⚠️ Common Mistakes to Avoid:

  • Poor stabilization
  • Wrong angle

💡 Pro Tip:

Stabilize vein below insertion site.

Step 5: Catheter Advancement

Advance catheter, remove needle, confirm blood return.

⚠️ Common Mistakes to Avoid:

  • Needle reinsertion
  • No blood return

💡 Pro Tip:

Advance catheter before removing needle.

Step 6: Securing

Secure catheter with tegaderm, connect tubing.

⚠️ Common Mistakes to Avoid:

  • Poor securing
  • Air embolism

💡 Pro Tip:

Flush with saline to confirm patency.

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Post-procedure Care

Post-procedure care involves securing the catheter, monitoring for complications, and timely removal when no longer needed.

Complications & Management

Complication Incidence Signs Management Prevention
Infiltration 5-10% Swelling, pain, coolness Remove catheter, apply pressure Confirm blood return
Phlebitis 3-8% Erythema, pain, warmth Remove catheter, warm compress Proper technique, timely removal
Infection 1-3% Erythema, purulent discharge Remove catheter, antibiotics Sterile technique
Hematoma 2-5% Bruising, swelling Pressure, ice Proper technique

Clinical Pearls

💡

Assess both arms for best vein selection.

🎯

Use non-dominant arm when possible.

⚡

Allow alcohol to dry completely.

🔍

Stabilize vein below insertion site.

📊

Advance catheter before removing needle.

🎨

Flush with saline to confirm patency.

⚠️

Monitor for complications post-procedure.