What you need to know about Peripheral IV

Have you ever been to a hospital? If so, one thing you'll almost certainly have to deal with is having a cannula inserted into your arm. In colloquial terms, it's "a needle in the arm." It's used for many things, including giving saline, giving antibiotics, giving blood... So this is what we medically call a peripheral IV . This is actually a very common thing. About 80% of patients admitted to hospitals around the world have to have an IV inserted in this way. So let's talk about all of this today.

Simply put, what is Peripheral IV?

A peripheral IV is a thin, flexible plastic tube that is inserted into one of your veins. We doctors call this a catheter . It is inserted into a vein using a small needle. Once the needle is in the vein, the needle is removed, leaving only the thin plastic tube inside the vein. That is the tube that is taped to your arm with a plaster.

This is called "peripheral" because it is given to veins that are far from the center of our body (chest), such as those in the arms and legs. This is the most commonly used intravenous treatment method in the world.

This is called by several other names:

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

Why do we need to put in a Peripheral IV?

A doctor or nurse will put you through an IV for a few main reasons. It allows blood to be drawn through it, and it also allows treatments to be given directly into your bloodstream. This allows the medication to be absorbed quickly and helps you recover faster.

The main situations in which an IV is used are:

• Give IV fluids: This is what we call saline. It is used to quickly provide fluids to the body in situations like dehydration, that is, when there is not enough water in the body.
• Administer medications: Medications that need to work quickly, especially antibiotics, are administered intravenously. Painkillers and other specialized medications can be given this way.
• Blood transfusions: When someone needs blood, blood is given through this IV line.
• Give liquid nutrition: This method is used to give nutrition directly into a vein to patients who cannot eat orally or absorb food through the intestines. We call this total parenteral nutrition (TPN) .

The most common places to put an IV are the back of the arm, the inside of the elbow, and sometimes the leg. In small babies, the small veins in the head are sometimes used, as they are easier to find.

What is the difference between other types of IV and Peripheral IV?

You've probably heard terms like PICC line and Central line. These are a little different from a Peripheral IV. Let's take a look at what the difference is.

Simply put, a peripheral IV is the simplest, safest, and easiest to insert. It's also less painful.

How does the process of putting in an IV happen?

Okay, now let's see what happens when a cannula is inserted into your arm. No one likes to be pricked, but knowing the process will help ease your fear a little.

1. Preparation

First, the nurse or doctor will ask you for your name and other details to make sure you are a good person. If you are afraid of needles, tell them about it. They will help you relax. Then they will ask you to rest your hand on something comfortable, such as a pillow.

2. Finding a vein

The next step is to find a good vein. The nurse will wash their hands, put on gloves, and examine your arm. They will look for a straight vein that is not inward-facing, does not branch, and is a bit larger.

• You've probably seen a rubber band ( tourniquet ) being applied to the upper arm. This is done to make the veins fill with blood and make them stand out more clearly.
• Then they tell you to shake hands.
• Palpate the vein with your fingertips to see how good it is and whether it is moving around.
• Sometimes, if it is difficult to find a vein, a special vein-finder device can be used.

3. Inserting the cannula

Once a good vein is found, a topical anesthetic can be applied to numb the area. This is especially useful for young children. The rubber band is removed at that time, as it takes about 30 minutes for the anesthetic to take effect.

Then, the area is thoroughly cleaned with antiseptic and the rubber band is tightened again.

Now is the most important part. The nurse will pull the skin of your arm tight with one hand. Stop the vein from moving. With the other hand, they will hold the needle and the plastic tube (cannula) around it. They will tell you, "The needle is going to be inserted," and they will insert the needle through the skin and into the vein at a very shallow angle.

When the needle enters the vein, a small drop of blood comes out behind the cannula. That means it's working properly. Then , as the needle is slowly pulled out, the plastic tube is pushed a little further into the vein. Finally, the needle is completely removed, and the rubber band is removed.

4. Securing

Now, all that's left inside the vein is that thin plastic tube. The area is cleaned thoroughly and covered with a transparent dressing. Then, the cannula is taped to the skin to keep it from moving. Finally, the date and time the cannula was inserted are written on the dressing.

Then, if necessary, some blood is taken for blood tests, and a saline flush is sent through the saline line to check if the line is working properly.

This entire process, if a vein can be easily found, takes less than a minute.

What are the risks and complications of this?

Although placing a peripheral IV is a very safe procedure, minor complications can sometimes occur. However, these are very rare.

• Infection: Germs can enter the area where the cannula was inserted or into the bloodstream. That's why it's important to keep the area clean.
• Bleeding or Hematoma: There may be a little bleeding from the puncture site, or blood may collect under the skin and turn blue.
• Thrombosis: A blood clot may form inside the vein around the cannula.
• Phlebitis: The vein becomes infected and may become red and painful.
• Blown vein: If the needle goes through the vein and punctures it, the medication or saline can leak out of the vein and into the tissue, causing the area to swell.
• Damage to nerves or arteries: This is very rare.

Can everyone easily get an IV?

No. Sometimes it is not possible to insert the cannula the first time. Research has shown that between 65% and 86% of cases are successful on the first attempt. However, between 8% and 23% of cases, it may be difficult to insert it.

There are several reasons why it may be difficult to put in an IV:

• History: If you have ever had difficulty getting an IV in the past.
• Dehydration: When the body lacks water, the veins shrink and become difficult to find.
• The nature of the veins: Some people's veins are invisible to the naked eye, or they are very thin.
• Skin color: Sometimes it can be a little difficult to find veins in people with dark skin.
• Other causes: Veins can be difficult to find due to factors such as drug use, scars from surgery, medical conditions such as diabetes, cancer, weight loss or gain, and chemotherapy.

Also, the data shows that it may be a little more difficult for women to get an IV than for men.

How long can one IV be left in?

Typically, according to hospital policy, a single peripheral IV cannula is left in place for 72 to 96 hours, which is about 3-4 days. If treatment is needed for longer than that, the old cannula is removed and a new cannula is inserted in a new location to reduce the risk of infection.