Peripheral IV

What is a peripheral IV?

A peripheral IV is a thin, flexible tube. It’s used to deliver treatments into a vein for different health conditions. They’re the most commonly used intravenous (IV) devices in the healthcare setting. Up to 80% of people admitted to the hospital need IV access during their stay. Around the world, healthcare providers use more than 1 billion peripheral IVs every year. Other names for a peripheral IV include:

• Peripheral IV catheter.
• Peripheral venous catheter.
• Peripheral IV line.

What is a peripheral IV used for?

Healthcare providers use peripheral IV lines to draw blood and give treatments, including:

• IV fluids.
• Medications, such as antibiotics.
• Blood transfusions.
• Liquid nutrition (total parental nutrition).

The most common peripheral IV sites include the back of your hand, inner elbow and foot. In infants, the scalp is the easiest placement. A peripheral line can remain in place for several days if needed. This can prevent the need for repeated needle sticks if you need ongoing treatment.

Peripheral IV vs. PICC line

A PICC (peripherally inserted central catheter) line is a type of central venous catheter. Central venous catheters are similar to peripheral IVs, but they’re longer and thicker. Healthcare providers use PICC lines to access the large veins in your chest when you need to get treatments through your veins over a longer period of time. Peripheral IVs are generally safer, easier to place and less painful than PICC placement.

Midline vs. peripheral IV

A midline is another kind of central venous catheter used when you need treatment for a longer period. They’re half as long as PICC lines and extend to just below your collarbone. People who can’t get PICC lines may get midlines instead.

What happens before a peripheral line placement?

Before a peripheral IV placement, a healthcare provider will ask to confirm your identity. They may also help put you at ease if you’re anxious or have a fear of needles. Then, they’ll have you rest the body part they’re going to use on a comfortable surface.

What happens during a peripheral IV insertion?

A healthcare provider will use peripheral IV insertion guidelines to properly place a line. First, they’ll wash their hands, put on a pair of gloves and look for a suitable vein to use. They prefer veins that are straight, away from the inner part of your body and not near points where the vein branches out. They’ll likely apply a tourniquet (a stretchy band) and have you make a fist. They may gently tap (palpate) the area with their fingertips to look for a large, nonmoving vein, as they can shift or roll. If the provider can’t easily find a vein, they may use a vein-finder device.

Once they find a suitable vein, the provider may apply a topical anesthetic to numb the area. This is more common with children. If they apply an anesthetic, they’ll remove the tourniquet while the numbing medicine takes effect. Then, they’ll clean the site with an antiseptic swab and reapply the tourniquet.

The provider will then hold the area still and taut with one hand and hold the needle and catheter in the other. The provider will give you a heads-up that a needle stick is about to happen, and then, they’ll insert the needle into your skin at a shallow angle. The needle will move through your skin and into your vein. The provider will gently advance the catheter into your vein and then remove the needle and the tourniquet.

What happens after peripheral IV placement?

After the healthcare provider places the peripheral line, they’ll carefully wipe down the area and cover the catheter with a see-through (transparent) dressing. They’ll secure the tubing to your skin with tape, and they’ll write the date and time on your dressing.

Then, they can draw blood if needed for laboratory testing. And they’ll attach the end of the IV tubing to the catheter and flush the line with saline to confirm adequate flow.

How long does peripheral IV placement take?

If a healthcare provider easily finds a suitable vein and has no problems with placement, the procedure should take less than a minute. If they have trouble finding a vein or have difficulty with insertion, the procedure could take longer. In addition, if the provider uses an anesthetic to numb the area, they may need to wait up to 30 minutes to attempt the placement.

What are the benefits of this procedure?

Peripheral IVs are the most common type of intravenous line. Many different types of healthcare providers (including first responders) have received training on peripheral line placement. Once a provider has placed the line, it can stay in for several days before needing replacing.

What are the risks or complications of this procedure?

It’s sometimes necessary to attempt peripheral IV insertion more than once, and the procedure can be uncomfortable. Complications of peripheral IV placement are rare but may include:

• Infection at the insertion site or in your bloodstream.
• Bruising (hematoma) or bleeding at the insertion site.
• Blood clot formation around the catheter in your vein (thrombosis).
• Inflammation in a vein (phlebitis).
• Blown vein.
• Artery, vein or nerve damage.

How successful is this procedure?

Healthcare providers successfully place peripheral IVs the first time in 65% to 86% of cases. They have difficulty with placement in 8% to 23% of cases. Factors that may lead to difficulty with peripheral IV placement include having:

• A history of difficult placement.
• Dehydration.
• Non-visible veins or very small veins.
• Darker skin tones.
• A history of nonmedical intravenous drug use.
• Scar tissue or previous injuries near IV sites.
• Health conditions such as diabetes, sickle cell disease and cancer.
• Underweight or obesity.
• Chemotherapy treatment.

In addition, healthcare providers tend to have more difficulty placing peripheral IVs in women and people assigned female at birth (AFAB).

How long can a peripheral IV stay in?

In most hospitals, healthcare providers must replace peripheral IVs every 72 to 96 hours.

A note from Cleveland Clinic

Healthcare providers use peripheral IV lines to draw blood and deliver treatments through a vein for various medical conditions. They’re very common and used all over the world. Peripheral IVs are the most common type of IV line used, and many different types of providers have received training on their placement. Once they’ve placed a line, it can stay in for several days before needing replacing, so it saves you from extra needle pokes. If you have questions about peripheral IV line placement, talk to your healthcare provider.