Intravenous Lines

Original Editor - Jin Yoo Top Contributors - Jin Yoo and Kim Jackson  

Introduction

In the acute care setting, intravenous (IV) lines have varied functions:

1. to infuse fluids, nutrients, electrolytes, and medication
2. to obtain venous blood samples
3. to insert catheters into the central circulatory system

Common areas of placement are in the forearm or back of the hand.

Peripheral IV (PIV)

Overview:

• Common and preferred method for short-term therapy (< 6 days)
• A short intravenous catheter is inserted by percutaneous venipuncture into a peripheral vein
• Held in place with a sterile transparent dressing to keep site sterile and prevent accidental dislodgement
• Upper extremities are the preferred sites for insertion
• Usually attached to IV extension tubing with a positive pressure cap

Chemical and mechanical complications include phlebitis, infiltration, extravasation, hemorrhage, and local infection.

Systemic complications include pulmonary edema, air embolism, catheter embolism, and catheter-related bloodstream infection.

Central Venous Catheter (CVC)

Overview:

• Also known as a central line or central venous access device
• Inserted into a large vein in the central circulation system (guided by ultrasound)
• Tip of catheter terminates in the superior vena cava leading to an area just above the right atrium
• Can remain in place for more than a year

Commonly seen in patients who:

• require antineoplastic medications
• are seriously/chronically ill
• require vesicant/irritant medications
• require toxic medications/multiple medications
• require central venous pressure monitoring
• require long-term venous access/dialysis
• require total parenteral nutrition
• require medications with a pH greater than 9 or less than 5 OR osmolality of greater than 600mOsm/L

Complications

Common complications with IV administration include cellulitis, phlebitis, thrombosis, sepsis, air embolus, and pulmonary thromboembolism.

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