By Ryan MacArthur |

Why do some patients have an IV placed in their arm while another may have an IV in the back of their hand? Healthcare providers can use several different access points on the body when administering IV therapy, and they decide which option is best for the patient on a case-by-case basis.

There are several different factors that are considered when determining the best IV site including vein visibility, the patient’s age, duration and frequency of therapy, and the medication being administered.

When selecting a site for IV access, medical personnel are ideally looking for thick or wide veins with healthy vein walls away from joints.

Hand

Peripheral IVs are ideal for short-term access and are relatively simple to insert. The CDC recommends using an IV site in the upper extremity of the body, so healthcare professionals typically choose sites that are easy to access such as the back of the hand.

The preferred veins are typically the ones located in your forearm or back of your hand. These are followed by the veins you can see in the crook of your arm, near your elbow.

In children, veins in the hands, wrists, feet, crook of the arm (Antecubital Fossa), and even the scalp – in babies less than 18 months old – are often ideal sites for IV therapy. Small children tend to be less cooperative and their small, mobile veins can make reliable vascular access more challenging.

Near the Elbow

When time is of the essence, EMS workers will often try to use the veins you can see in the crook of your arm, near your elbow because they are easy to visualize with some patients.

However, since this is an area of flexion, IV dislodgement and infiltration can be common. Some experts recommend avoiding using this IV site location except in emergency or short-term care.

Chest

A nurse will usually administer IV fluids, medications, etc. either in large quantities or over a longer period of time (e.g. chemotherapy, transfusions, and frequent blood sampling) via a central line. A doctor will place the line directly into a vein in the patient’s chest in order to deliver medications that can sometimes be harmful to peripheral veins.

Healthcare providers may place a central IV when longer term access is needed. Common sites for central access are the arm, neck and chest.

The choice of IV site is guided by several factors and must be tailored to each patient’s needs, their body, and the type of infusion. Don’t be afraid to speak to your doctor or nurse about the site they choose to place your IV.

 

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References:

Peripheral Intravenous Access – https://www.med.uottawa.ca/procedures/iv/#05

Best Places to Find a Vein for an IV – https://forum.nursejanx.com/t/best-places-to-find-a-vein-for-an-iv/46

Venous access – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2682308/

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