By Ryan MacArthur | 

Intravenous (IV) therapy involves the delivery of medication, blood or fluids directly into the bloodstream. While Peripheral IVs are more common, doctors and nurses also use Peripherally Inserted Central Catheters (PICC lines) when a patient requires chemotherapy, medication, nutrients or fluids for extended periods of time. Discover the differences between these two methods and the risks associated with each type of IV treatment.

Peripheral IV Overview

Healthcare providers use an estimated 200 million peripheral intravenous catheters each year, making them the most common form of IV treatment. Typically, a nurse will place a peripheral IV in a patient’s arm or hand and, depending on the hospital or facility and type of treatment, can leave it in the patient for up to four days.

What are the Dangers of a Peripheral IV?

Because almost half of all peripheral IVs fail, it’s critical to keep a close eye on complications like infiltration, extravasation, phlebitis, hypersensitivity, and infection. Issues can range from minor inconveniences like swelling and discomfort to severe pain, limb loss, and even death in the most extreme cases.

How Do I Know When Something is Wrong?

In most cases, the presence of swelling, burning, tightness, coolness, blistering, and redness in and around the IV site indicate something is wrong. You should alert your medical team immediately if you notice any of these symptoms during IV therapy.

PICC Line Overview

PICC lines are much more invasive and long-lasting (sometimes up to 12 months). A doctor will insert the line somewhere above the elbow in either the cephalic vein, basilic vein, or brachial vein before carefully advancing towards a larger vein closer to the heart. Patients usually receive an anesthetic prior to the procedure and have an x-ray done afterward to ensure the line is in the right position.\

What are the Dangers of a PICC Line?

Inserting a PICC line is more invasive than administering a peripheral IV, which also means there can be added risks. Deep Vein Thrombosis and bloodstream infections are two of the more serious complications that can occur. Extravasation, or the leaking of vesicant fluids (like chemotherapy drugs) into the surrounding tissue, can be particularly dangerous.

How Do I Know When Something is Wrong?

Similar to Peripheral IVs, the appearance of swelling, tenderness or discoloration of the skin are strong indicators that a PICC line has failed. Symptoms of a bloodstream infection include fever and chills, rapid pulse, nausea and vomiting, and a low body temperature.

What Should I Do If My PICC Line or Peripheral IV Fails?

Always alert a healthcare professional as soon as possible if you are experiencing any symptoms of IV failure. Catching an IV failure early can make a significant difference in the severity of complications.

References –
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The safe insertion of peripheral intravenous catheters: a mixed methods descriptive study of the availability of the equipment needed:

Complications of Peripheral I.V. Therapy:

Risk factors for complications in peripheral intravenous catheters in adults: secondary analysis of a randomized controlled trial:

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