A Peripheral Intravenous Line, or PIV line, is a short, flexible catheter inserted into a small vein to provide access to the bloodstream. This device is the most frequently used invasive procedure in healthcare settings globally. The term “peripheral” means the catheter accesses smaller veins closer to the skin’s surface, usually in the limbs, rather than larger, deeper veins near the heart. PIV lines enable healthcare providers to quickly and reliably administer treatments directly into the body’s circulation.
Where PIV Lines are Placed and Why They are Used
PIV lines are typically placed in the veins of the upper extremities, such as the back of the hand, the forearm, or the inner elbow area. The procedure involves cleaning the skin, inserting a needle with the catheter over it into the vein, and then removing the needle, leaving only the soft catheter inside the vessel. In infants and young children, alternative sites like the veins in the feet or even the scalp may be used due to easier accessibility.
The placement of a PIV line is a relatively simple procedure that provides immediate vascular access for various routine medical needs. The primary function is to deliver intravenous fluids to correct dehydration or maintain hydration, a process often called “running an IV.” PIV lines are also used to rapidly administer medications, such as antibiotics or pain relief, directly into the bloodstream for quick effect.
Furthermore, this access allows for the transfusion of blood products, including packed red blood cells or platelets, when a patient requires them. A PIV can also serve as a convenient point for drawing blood samples for diagnostic testing, preventing the need for multiple, separate needle sticks. Because they access smaller veins, PIVs are generally intended for short-term use during a patient’s stay.
Practical Care and Duration
A PIV line is designed to remain in place for a short duration, usually needing replacement within 72 to 96 hours to minimize complications. Proper maintenance is required to ensure the line remains functional and to prevent infection at the insertion site. Patients are advised to keep the area dry and avoid bending the limb at the insertion site to prevent the catheter from becoming dislodged or irritating the vein.
The patient should monitor the insertion site for specific signs of potential complications that necessitate removal of the line. One common issue is infiltration, which occurs when the fluid leaks out of the vein into the surrounding tissue, causing swelling, coolness, and discomfort around the site. Another complication is phlebitis, or inflammation of the vein wall, which presents as pain, redness, and warmth tracing along the path of the vein.
Signs of a localized infection include pus-like discharge or increasing pain and tenderness at the insertion point. If any of these issues arise, the line is removed. This is a quick process involving simply pulling out the soft catheter and applying pressure to the site.
PIV Lines Compared to Central Access Devices
A PIV line is fundamentally different from a Central Venous Catheter (CVC) or a Peripherally Inserted Central Catheter (PICC line) based on location, duration, and use. The PIV accesses small, peripheral veins in the extremities. A central access device is a much longer catheter whose tip terminates in a large vein near the heart, such as the superior vena cava. This difference in tip location dictates the types of treatments that can be safely administered.
PIV lines are strictly for short-term use, typically lasting only a few days before needing replacement, making them ideal for most acute care needs. Central access devices are designed for long-term therapy, allowing for treatment that may last weeks or months. The high blood flow in the central veins allows for the safe infusion of highly irritating solutions, such as specific chemotherapy drugs or certain nutritional formulas, which would damage the smaller, peripheral veins.
Central lines are also used for complex monitoring and rapid, high-volume fluid delivery, which is not possible with a PIV line. Because central access devices are more complex and access a deeper vascular system, they carry a higher risk of serious infections, such as bloodstream infections. PIV lines are prone to local issues like phlebitis but have a lower risk profile for severe, systemic infections compared to central counterparts.