A Peripheral IV, commonly abbreviated as PIV, is a medical device widely used to gain temporary access to a patient’s bloodstream. It stands for Peripheral Intravenous, and its use is one of the most frequent invasive procedures performed in healthcare settings globally. This device allows healthcare providers to quickly and safely deliver various therapies directly into the venous system. This overview explains what the PIV is, how it is used, the placement process, and how to manage the device.
What a Peripheral IV Line Is and Where It Is Placed
The peripheral intravenous line is a small, flexible plastic tube known as a catheter or cannula. This specialized catheter is inserted into a peripheral vein, meaning a vein located outside the chest or abdominal cavities. The most common insertion sites are the veins on the back of the hands or the forearms, though veins in the feet may be used in some situations.
The device is composed of the catheter itself, which remains inside the vein, and an external hub. The hub connects to the administration set, such as IV tubing or a needle-free connector, allowing fluids and medications to be introduced. PIVs are typically secured to the skin using a sterile, transparent dressing, which keeps the site clean and allows healthcare staff to monitor the insertion point.
Common Medical Applications of a PIV
The primary function of a PIV is to establish direct access to the circulatory system for therapeutic purposes. One of the most frequent uses is administering intravenous fluids, such as saline or dextrose solutions, to correct dehydration or maintain fluid balance. This process is particularly important when a patient is unable to drink or requires rapid volume replacement.
PIVs also serve as a route for delivering numerous medications directly into the bloodstream. These can include antibiotics, pain relief medications, or other drugs that require rapid or continuous dosing. This method ensures the medication is absorbed quickly and completely, bypassing the digestive system.
A PIV can also facilitate the infusion of blood products, such as packed red blood cells or plasma, during procedures or after significant blood loss. The device can also be utilized to draw blood samples for laboratory analysis, providing a convenient access point without requiring additional needle sticks.
The Insertion Process and Expected Duration of Use
The process of placing a PIV begins with the selection of a suitable vein, often in the non-dominant arm, and preparation of the site. A tourniquet is applied a few inches above the chosen site to temporarily pool blood and make the vein more prominent. The skin over the insertion area is then thoroughly cleaned with an antiseptic solution and allowed to dry completely to minimize the risk of infection.
The healthcare provider inserts the device, which consists of the flexible catheter loaded over a sharp, hollow needle, into the vein at a shallow angle. A visible “flashback” of blood into the device indicates that the needle tip has successfully entered the vein. The needle, which acts as a guide, is then withdrawn, leaving only the soft plastic catheter threaded inside the vessel.
Once the catheter is in place, the tourniquet is removed, and the catheter is connected to the IV tubing or a cap. The device is secured to the skin with a transparent dressing and tape to prevent accidental dislodgment. PIVs are generally considered short-term devices and are typically replaced every 72 to 96 hours to prevent complications like infection and phlebitis.
Care and Recognition of Potential Complications
Proper care of the PIV site after insertion involves keeping the transparent dressing intact and dry. Patients should avoid getting the site wet and must take care not to pull or snag the IV tubing, which could dislodge the catheter. Any manipulation of the line, such as flushing or medication administration, is performed using strict aseptic technique to prevent bacteria from entering the bloodstream.
Patients should monitor the site for signs of common complications. One frequent issue is infiltration, which occurs when fluid leaks out of the vein into the surrounding tissue. Signs of infiltration include swelling, coolness, or blanching of the skin around the PIV site, or a change in the infusion flow rate.
Another potential issue is phlebitis, which is inflammation of the vein’s inner lining. This manifests as redness, warmth, tenderness, or pain tracing along the path of the vein. Signs of a localized infection, such as pus or discharge at the insertion site, or the development of a fever, also necessitate line removal. If any of these signs appear, the catheter is removed, and a new site is chosen for access, as these issues are usually localized and resolve quickly once the device is taken out.