An intravenous (IV) line is a thin, flexible tube, or catheter, that healthcare providers insert directly into a patient’s vein. This allows for the immediate delivery of fluids, medications, or nutrients into the bloodstream, bypassing the digestive system for rapid absorption. Peripheral IVs, the most common type, are typically placed in the veins of the arms or hands.
Primary Placement Locations
IVs are most commonly placed in the veins of the upper extremities, specifically the back of the hand, the forearm, and the bend of the elbow. These areas contain several superficial veins suitable for cannulation.
The dorsal venous network, located on the back of the hand, is a frequent site for IV insertion due to its visible and accessible veins. Moving up the arm, the cephalic vein runs along the thumb side of the forearm and arm, often chosen for its size and ease of palpation. The basilic vein, found on the pinky side of the forearm and arm, is another large superficial vein. At the bend of the elbow, the median cubital vein is a prominent superficial vein connecting the cephalic and basilic veins, often chosen for its large diameter and stability.
Factors Guiding Site Selection
Healthcare professionals carefully select an IV site based on several practical considerations to ensure patient comfort and treatment effectiveness. Vein size and visibility are important, as larger, more easily palpable veins simplify the insertion process and reduce complications. The condition of the vein is also assessed, avoiding those that are hardened, bruised, or recently used for IV access.
Patient comfort and activity levels are significant factors, as sites near joints, like the bend of the elbow, may cause discomfort or restrict movement, especially for longer IV durations. The type and duration of the fluid or medication being administered also influence the choice; some substances require larger veins or specific flow rates. Patient history, including previous IV sites or existing medical conditions, is considered to avoid areas with potential issues. Additionally, if a patient has multiple suitable veins, preference is often given to a site on their non-dominant arm or hand.
The IV Insertion Process
The process of inserting an IV involves several precise steps. Healthcare providers first gather all necessary supplies, including the IV catheter, tourniquet, antiseptic wipes, and a transparent dressing. They then identify a suitable vein, often applying a tourniquet above the chosen site to make the veins more prominent.
Before insertion, the skin at the selected site is thoroughly cleaned with an antiseptic solution and allowed to air dry. With the vein stabilized, the needle, which carries the flexible plastic catheter, is inserted into the skin. As the needle enters the vein, a “flashback” of blood confirms successful vein entry.
Once flashback is observed, the angle of the needle is lowered, and the catheter is gently advanced into the vein while the needle is withdrawn. The flexible catheter remains in the vein, and the needle is disposed of in a sharps container. The catheter is then secured to the skin with tape and a transparent dressing. Finally, the IV line may be flushed with saline to ensure it is patent.
What to Expect After Placement
After a peripheral IV is successfully inserted and secured, it is ready to deliver prescribed fluids or medications. The IV can remain in place for varying lengths of time, depending on the treatment plan. Patients might experience some mild sensations at the insertion site, such as a sharp pinch during insertion, followed by tenderness or slight warmth.
It is common to notice minor bruising or slight swelling around the IV site, which typically resolves within a few days. While these sensations are generally temporary, it is important to notify a healthcare professional if there is significant pain, increased redness, swelling, or any leakage around the site, as these could indicate a complication.