IV gauge

[debbiernbsn]

At both L&Ds I've worked at the practice was to place an 18 gauge cath. This was requested mainly by anesthesia. Is everyone else doing this too as standard practice? If not, do you have any evidence to show that it's not necessary to have that big of a gauge? Thanks for any input!

[Loo17]

My hospital guidelines state to use the smallest possible gauge that is appropriate based on recommendations from the INS.

"The Infusion Nurses Society standards of practice states "the smallest gauge and length with the fewest number of lumens and shall be the least invasive device needed to accommodate and manage the prescribed therapy." A small gauge catheter results in less trauma to the vein, promotes proper hemodilution of the solution, and allows adequate blood flow around the catheter wall. All these factors promote increased catheter dwell time and improve patient outcomes."

You can read more about their guidelines on their website. http://infusionnurse.org/2013/03/

I think an 18G as a standard in your population is too big and generally not necessary. Bigger isn't always better.

I work in a busy level 1 ED in the adult section and usually put 20G, sometimes 22g and sometimes 18g. I have placed a handful of 16g.

[calgrrl]

During my training one of my preceptors discussed the risks of hemorrhage and the need to have access through which one can transfuse blood if needed. I am not sure it's the official policy, but I have only seen 18 ga used.

[eager1hasbegun]

I was also taught that emergent blood transfusion was the reason for the standard 18g. I'm a traveler and that's what I've seen everywhere I've been. Looks like the Infusion site says that it's recommended for trauma or surgery, which makes sense for our specialty.

[bagladyrn, RN]

18 ga. is the standard at most places. The smallest I'd be comfortable with is a 20 ga., having seen how fast an OB patient can bleed out and how difficult it can be to start another line while hemorrhage is occurring.

[Elvish, BSN, DNP, RN, NP]

18 is standard, 20 if they are a hard stick.

Baglady is right. OB hemorrhages are very bad when they happen (before, during, or after delivery). We don't mess around. The OBs are starting to get more aggressive with massive transfusion protocols, and with that an 18 is the smallest our OBs want. I'd much rather try and get one in healthy, well-hydrated veins than ones that have already clamped down trying to preserve vital organs.