A peripheral intravenous (PIV) line is a small hollow tube that is inserted into a vein. This intravenous line can then be connected to special tubing. Medications, fluids, and blood can be administered directly into the vein through the peripheral intravenous line.
There are several types of peripheral intravenous lines. The most common lines are inserted in the hospital by a nurse or trained medical personnel. This type of peripheral intravenous line is a short catheter usually measuring a few centimeters long. These catheters come in varying diameters called gauges. An 18-gauge catheter is bigger in diameter than a 22-gauge catheter.
The veins in the hands or the arms are the most common sites for insertion with these peripheral intravenous lines. The medical personnel must determine the type of treatment that is needed and insert the appropriate size needle. For example, a patient who will be receiving a blood transfusion will need a larger PIV than a patient who is just receiving intravenous fluids. Sometimes when there are no usable veins in the upper body, the veins in the legs and feet may be used for intravenous line insertion.
Peripherally inserted central catheters (PICC) lines are also considered to be peripheral intravenous lines. These types of intravenous lines are usually inserted through a large vein in the upper arm under the guidance of ultrasound. Once the line enters the large vein, it is then threaded up the arm and down into the superior vena cava. Correct placement of the PICC line must be confirmed by X-ray before it is used.
Only specially trained nurses and medical personnel may insert PICC lines. The biggest advantage to these intravenous lines is they can stay in place for months with proper care. An individual who requires long term chemotherapy or artificial nutrition can benefit from a PICC line.
A central venous catheter, commonly called a central line, is considered a peripheral intravenous line. This is usually inserted in the operating room by a surgeon or at the bedside by a qualified physician. This hollow tubing is most generally inserted in the large internal jugular vein of the neck or the subclavian vein under the collar bone. It is threaded until the tip reaches the superior vena cava.
Central lines are usually inserted when there is a lack of suitable veins in the arms and legs. They may also be inserted in trauma situations because they can handle rapid infusions of large volumes of fluids. As with the PICC line, central line placement should be confirmed by X-ray.
Removal of all types of peripheral venous lines is simple. The tape that is securing the line is removed first. Any sutures that may be holding the line in place are cut. Then the line is pulled out gently in one steady motion. Pressure is applied with a gauze if any bleeding is present.