Peripheral Intravenous Access
Peripheral intravenous (PIV) device placement is the most common method for obtaining vascular access in the emergency setting. Establishing PIV access can be quick, relatively painless, and allows for blood testing and medication or fluid administration. Duration of treatment, indication for treatment, type of solution, vein availability, and age are all factors to be considered when selecting the type and location of PIV access.
While all of these factors need to be considered, a guideline for catheter gauge selection is the following: 24-gauge for infants or patients with fragile veins, 22-gauge for children or elderly patients needing intermittent infusions, 20-gauge for adults or those with continuous infusion needs, and 18-gauge to 14-gauge (or the largest gauge possible in smaller patients) as necessary for trauma management or high-volume fluid resuscitation. In general, choosing the smallest gauge and shortest length catheter for the needs of the patient is the best practice.3
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