IV Sizes?

Everline · Nov 30, 2014

It depends. What will the IV be used for? What is the age and status of the patient? Where will the IV be inserted....etc.

Jennx · Nov 30, 2014

Just fluids, and on the dorsal side of the hand. Pt. is 90 years old.

ixchel · Nov 30, 2014

It really depends on the patient, the expected course of treatment, the ease of insertion, the big picture. By default, we go with 20s. If they'll be going for a cath or other procedure that may result in rapid IV infusions, 18s are what is tried for. If insertion is really hard and it's not likely the patient will need blood, a 22 may be necessary. I'd say 90% of the time, though, they get 20s.

RN403, BSN, RN · Nov 30, 2014

With the patient information given, what size do you think would be appropriate and why?

Agree with other posters, depends on the age of the patient, type of fluids that will be running, and if you would anticipate that tjey would need blood or any other type of rapid infusions, etc.

ixchel · Nov 30, 2014

Just fluids, and on the dorsal side of the hand. Pt. is 90 years old.

I just saw this. For me personally, if the veins look little, I'll go with a 22. I'll try for a 20, though, because if anything comes up in the future, a new IV will have to be started with a 20.

Be warned - 90 year old veins roll. Hold that sucker down!

ixchel · Nov 30, 2014

This is probably a dumb question, but when the IV nurse goes to insert an IV into a patient, what is usually the size of the IV?

BTW - no question is a dumb question! Just wait until you start priming lines and can't figure out how to get a bubble that's in the middle out. I had a whole bunch of dummy moments in my first months! This is stuff that will be common sense, but not until you've been exposed to it for a good long time with repetition, repetition, repetition.

Esme12, ASN, BSN, RN · Nov 30, 2014

ixchel is right...There are no dumb questions. The actual answer is...the smallest catheter that causes the least amount of trauma to the vein for the purpose that you are needing the IV for. A 20 angio cath is the common go to...however those little fragile veins on a 90 year old will call for a #22.

Medscape: Medscape Access

akulahawkRN, ADN, RN, EMT-P · Dec 1, 2014

My three go-to catheter sizes are 18, 20, 22. These three will allow flow rates that are usually prescribed for most patients unless they need to get fluid in FAST. My normal field go-to is an 18 ga. I can count with my fingers the number of times I've ever had to place a catheter larger than that.

PMFB-RN, RN · Dec 1, 2014

ixchel is right...There are no dumb questions. The actual answer is...the smallest catheter that causes the least amount of trauma to the vein for the purpose that you are needing the IV for. A 20 angio cath is the common go to...however those little fragile veins on a 90 year old will call for a #22.
Medscape: Medscape Access

Agreed, except most of the hospitals in my area have gone to 22ga as the standard size. In the case mentioned by the OP I would probably place a 24ga.

To the OP. Back in the old days everybody used to get much larger IVs than they needed "just in case". This way of thinking has been obsolete for many years now. The fear was what if this patient needs to be fluid resuscitated? Well we no longer need to worry about not being able to get access in an emergency so there is no reason to place all these huge IVs in people.

Unless it is LIKELY that you will have to give a lot of fluid fast, like in a GI bleed or trauma a 22ga should be the go to size IV with 24ga available for those who only need an IV for IVP meds, and MIVF.

Smaller in MUCH better for medication administration or when running drips like amioderone or dilatizem and others through a PIV.

allnurses Guide · Dec 1, 2014

We tend to go for an 18 in most adults in an ER; way too many times something changes and we need the larger line (usually for a stat CT). But we also are danged good at the 24 on difficult sticks.

rob4546, ADN, BSN, MSN · Dec 1, 2014

This is a fun post. I would say that it depends on what the veins look like. I work outpatient surgery and regularly see patients 90+ and the CRNA's like the IV placed in the dorsal aspect of the hand. I can't say I would forget about the 20g but I usually place a 22g. These are not patients that need a great amount of fluids fast so I can even get away with a 24g.

Is this a test question because they may be looking for a specific answer depending on situation. If you want general knowledge then evaluate patients on a one-on-one basis. I have placed larger than a 20g in grandma going in for a total hip (but it was an AC and she was an active 90).