Peripheral venous access refers to a vascular catheter that terminates in a peripheral vein in an extremity, the scalp, or trunk. Indications may include IV fluid therapy, blood sampling, and medication administration. Contraindications include infection, tissue compromise, and thrombosis. It is important to determine the best site for insertion, select the right catheter size, and ensure all necessary equipment is at the bedside before performing the procedure. IV infiltration and IV extravasation are common complications.
Determine the best insertion site. 
- Common sites in adults and children
- Additional options for children include scalp veins and lower limb veins.
- Avoid veins that are:
- Select the appropriate catheter size. 
- Consider for the insertion site in children. 
- Ensure all necessary equipment is at the bedside.
- Place a tourniquet 5–10 cm above the site of insertion.
- Prepare the site with an antiseptic solution.
- Apply traction to the skin with the nondominant hand.
- Direct the needle into the vein at a 10–30° angle with the bevel facing upward.
- Advance until blood flashback is seen.
- Depress the angle of the needle and advance another 1–2 mm.
- Slide the catheter off the needle.
- Flush with saline or aspirate blood.
- Apply a sterile dressing.
|Common pitfalls in peripheral intravenous line placement |
|Challenge||Interventions to consider|
|No visible vein|
|Needle does not enter vein|
|Catheter does not advance|| |
|Fluid does not run|| |