IV 'definitions'

Originally posted by alongbella

Hi! Bear with me as I have never posted on this site. I am a 41 year old RN student. I was asked by my clinical instructor to define proximal IV, medial IV, and distal IV. Now I know what proximal, distal, and medial mean but certainly the terms mean something more when used in reference to IV tubing. For example, is a distal IV only used for certain medications or WHAT!!

Maybe I am reading too much into this as I could not find anything on the internet and am not even sure what I should be looking up. But my instructor definitely said she wants details. Please help as it is due on Friday and it is Monday today!!!!

THANKS:D

A distal IV is used in Chemotherapy. When not using a central line, a distal site is chosen for vesicant medications. Best way to explain what a vesicant does, it basically eats tissue if infiltrated, now, we don't even use the term infiltrate for this situation, we call in infiltrate's big brother extravisate.

Extravisation is when all the tissue has the potential to eat the skin down to the muscles and tendons. We want a small hand vein to use. Why not the big ante cubital vein? Because we can't see if the bottom of the vein is punctured and leaks. There is not way to see the extravisation until it is way too late and here come the surgeries and skin and muscle grafts. The small hand vein will easily show any fluid leaking in the tissues and can be treated.

Medial IV's are used for what is called "long lines." Special midlines which are 9 inches long can prevent local veins from becoming sclerotic from caustic medication like vancomycin. They are still considered peripheral lines. Medial IV's are also used to insert Peripherally Inserted Central Catheters, or PICC lines. They are considered central lines if the enter the venous system at the level of the axillary veins or higher. Also any IV in the antecubital area is amedial IV.

Proximal Vs distal. It is possible to re use a vein that has had a lower infiltration. You always start low to insert an IV, if it infiltrates you can use the same vein which is still intact approximately 3 inches higher from the infiltration site to insert a new IV. The old site is considered distal, the new site is proximal.

God help you trying to figure out this gibberish, but as a vascular access clinician, we make everything difficult.