Peripheral IV Overview

Healthcare providers use an estimated 200 million peripheral intravenous catheters in the US each year, making them the most common form of IV treatment.¹ Typically, a nurse will place a PIV in a patient’s arm or hand and, depending on the facility and type of treatment, can typically last up to several days.

What are the Dangers of a Peripheral IV?

Because almost half of all peripheral IVs fail², 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 with my PIV?

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

A PICC line is a thin, long tube that healthcare providers insert into a major vein that connects directly into the heart. 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.

PICC lines allow doctors and nurses easy access to the patient’s veins for long-term IV treatments, like chemotherapy, blood draws and nutrition. While a growing number of clinicians are utilizing PICC lines over femoral catheters and internal jugular catheters for vascular access, PICC lines are not without risks and potential complications.

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 (DVT) and bloodstream infections are two of the more serious complications that can occur.

Because PICC lines lie deep within the bloodstream, they can provide a freeway for bacteria to enter a patient’s body. Serious issues like Central Line Associated Bloodstream Infections (CLASBI) and blood clots can also arise and present dangerous threats to patient safety. Extravasation, the leaking of vesicant fluids (like chemotherapy drugs) into the surrounding tissue, can be particularly dangerous.

According to a University of Michigan Medical School research team that focused their studies on blood clots and PICC lines, the risk of blood clots and deep vein thrombosis haven’t received enough attention from healthcare providers and put patients at risk. The team also said, “patients who had any kind of surgery during their hospital stay, or had any kind of deep clot in their medical history, were more likely to get a DVT associated with their PICC.”³

How Do I Know When Something is Wrong with my PICC?

Similar to PIVs, 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, 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.

Don’t be afraid to ask your healthcare professional about the pros and cons of administering medications, and why a PICC or PIV is the best solution for you. If you still have questions about IV therapy, we also have a blog answering the ten most commonly asked IV questions.