IV SITE

IV SITES
• PERIPHERAL
• SUPERFICIAL VEINS OF FOREARM, HAND, AND SCALP OF
CHILDREN
• ARM VEINS - COMMONLY USED
• RELATIVELY SAFE AND EASY TO ENTER
• CHOSE SITE - DOES NOT INTERFERE WITH MOBILITY
• USE MOST DISTAL SITE OF THE ARM OR HAND FIRST
• THIS PERMITS SUBSEQUENT IV ACCESS SITES TO BE
MOVED PROGRESSIVELY UPWARD

• IS THE ANTECUBITAL FOSSA A PREFERRED IV SITE?

• NO - LIMITS MOBILITY
 OTHER IV SITES TO BE CAUTIOUS OF:

• LEG VEINS SHOULD RARELY BE USED

• HIGH RISK OF THROMBOEMBOLISM

• AVOID VEIN ACCESS DISTAL TO A PREVIOUS IV INFILTRATION

• AVOID SCLEROSED OR THROMBOSED VEINS
• AVOID AN ARM WITH AN ARTERIOVENOUS SHUNT OR FISTULA
• AVOID ARM AFFECTED BY EDEMA, INFECTION OR BLOOD CLOT
• AVOID ARM ON THE SIDE OF A MASTECTOMY - IMPAIRED LYMPHATIC FLOW.
 PICC LINE (PERIPHERALLY INSERTED CATHETER)

• CAN BE INSERTED BY NURSES WHO

HAVE HAD SPECIAL TRAINING
• LONG CATHETER INSERTED INTO
ANTECUBITAL VEIN WITH TIP
POSITIONED IN SUPERIOR VENA
CAVA
• USE FOR IV ANTIBIOTICS FOR
SEVERAL WEEKS OR TPN
• LESS RISK OF COMPLICATIONS
CENTRAL LINE IV THERAPY

• CENTRALLY INSERTED CATHETERS -

SPECIAL CATHETER INSERTED INTO
A LARGE VEIN IN THE NECK OR
CHEST (SUBCLAVIAN OR JUGULAR)
• THREADED THROUGH INTO THE
RIGHT ATRIUM
• TIP RESTS IN DISTAL END OF
SUPERIOR VENA CAVA
 USE OF CVC’S (CENTRAL VENOUS CATHETERS)
Medication administration
•• Chemotherapy- infuse irritating or vesicant
•• Cancer
medications
•• Infection •• Long-term administration of antibiotics

•• Infusion of parenteral nutrition (PN)

Nutritional replacement
•• Able to infuse higher dextrose solutions through
central line than peripheral line
 ADMINISTRATION OF IV FLUIDS
• USE AN IV INFUSION SET
• A DRIP CHAMBER IS CONNECTED TO
THE IV BOTTLE OR BAG
• FLOW RATE IS ADJUSTED TO DROPS
PER MINUTE (GTT/MIN) WITH ROLLER
CLAMP
• INJECTION PORTS - LOCATED ON THE IV
TUBING & ON MOST IV SOLUTION BAGS
• ALLOW FOR INJECTION OF
MEDICATIONS DIRECTLY INTO IV BAG OR
IV LINE
• INJECTION PORTS ALSO ALLOW FOR
ATTACHMENT OF SECONDARY IV LINES
FOR IVPB MEDICATIONS
COMMON COMPLICATIONS OF PERIPHERAL
IV THERAPY
 PHLEBITIS : INFLAMMATION OF A VEIN

• SIGNS & SYMPTOMS OF PHLEBITIS

• REDNESS, SWELLING, PAIN, AND
EDEMA AT THE INSERTION SITE
AND/OR ALONG THE VEIN
• TREATMENT - REMOVAL OF
CATHETER & APPLICATION OF WARM
SOAKS
 INFILTRATION : VENIPUNCTURE DEVICE IS
DISLODGED FROM THE VEIN
• S & S:
• LOCAL EDEMA
• SKIN BLANCHING
• SKIN COOLNESS
• LEAKAGE AT THE PUNCTURE SITE
• PAIN & FEELINGS OF TIGHTNESS
• BLANCHING AT THE SITE
• ABSENT BACKFLOW OF BLOOD

• TREATMENT:
• DISCONTINUE THE IV & MONITOR SITE
 WHICH IS IT?

• REDNESS • EDEMA
• SWELLING • SKIN BLANCHING
• SKIN COOLNESS
• PAIN AND EDEMA AT THE INSERTION SITE
AND/OR ALONG THE VEIN • LEAKAGE AT THE PUNCTURE SITE
• ABSENT BACKFLOW OF BLOOD

• PHLEBITIS
• INFILTRATION
 VARIETY OF WAYS FOR
IMPLEMENTING IV THERAPY