What is a Peripheral IV Line?
A peripheral IV (intravenous) line is a small, flexible tube inserted into a patient's vein, typically in the hand or arm. It is used to administer medications, fluids, and nutrients directly into the bloodstream. This is a common procedure in nursing and is essential for patient care in various clinical settings.
Indications for Peripheral IV Line
Peripheral IV lines are indicated for several reasons:
- To deliver intravenous fluids to maintain or restore fluid balance.
- Administer medications that are not suitable for oral intake.
- Provide blood products or parenteral nutrition.
- Facilitate diagnostic testing requiring intravenous contrast.Preparation and Insertion
Before inserting a peripheral IV line, nurses must:
1. Verify Physician's Order: Ensure there is an appropriate order for IV therapy.
2. Gather Supplies: This includes gloves, antiseptic wipes, IV catheter, tourniquet, sterile dressing, and tape.
3. Patient Education: Explain the procedure to the patient to reduce anxiety and gain consent.
4. Site Selection: Choose an appropriate vein, avoiding areas of joint flexion and sites previously used.Insertion Technique
The steps for insertion include:
1. Hand Hygiene: Perform hand hygiene and wear gloves.
2. Apply Tourniquet: Place a tourniquet above the selected insertion site to engorge the vein.
3. Clean the Skin: Use antiseptic wipes to clean the area, reducing infection risk.
4. Insert the Catheter: Insert the catheter at a 15-30 degree angle until blood return is observed.
5. Secure the Line: Once the catheter is in place, remove the tourniquet, secure the catheter with a sterile dressing, and tape it down.Complications and Management
Some common complications include:
- Infiltration: Occurs when IV fluids enter surrounding tissues. Signs include swelling and coolness at the site. Management involves stopping the infusion, removing the IV, and applying a cold or warm compress.
- Phlebitis: Inflammation of the vein, characterized by redness, warmth, and pain. Treatment includes removing the IV and applying a warm compress.
- Infection: Localized or systemic infection, indicated by redness, pus, or fever. Preventive measures include proper aseptic technique and monitoring for signs of infection.Maintenance and Monitoring
Proper maintenance and monitoring are crucial to ensure the effectiveness and safety of the peripheral IV line:
- Check for Patency: Regularly flush the IV line with saline to prevent clotting.
- Inspect the Site: Assess for signs of infection, infiltration, or phlebitis every shift.
- Change Dressings: Replace dressings if they become damp, soiled, or loose.
- Documentation: Record the insertion date, site condition, and any complications in the patient's chart.Removal of Peripheral IV Line
When the IV line is no longer needed or complications arise, it should be removed:
1. Hand Hygiene: Perform hand hygiene and wear gloves.
2. Explain the Procedure: Inform the patient about the removal process.
3. Remove the Dressing: Carefully remove the tape and dressing.
4. Withdraw the Catheter: Gently pull out the catheter and apply pressure to the site with gauze.
5. Apply a Bandage: Once bleeding stops, place a sterile bandage over the site.Conclusion
Peripheral IV lines are essential tools in nursing for administering treatments directly into the bloodstream. Proper insertion, maintenance, and monitoring are vital to minimize complications and ensure patient safety. Nurses play a critical role in managing IV therapy, from insertion to removal, and must be vigilant in their care to provide the best outcomes for their patients.
