Large vein?

Some drugs are very irritating to veins. The smaller the vein, the better the chance of irritation and complications such as blown IV, phlebitis. It is up to the nurses judgement, along with any hospital policy or best practice standard, to decide to start an IV in a larger vein. Theoretically, the IV should be started in a large vein, in a non-bending area to start with - not those little hand veins that some nurses like to use. Of course there are those LOP (little old people) that you couldn't find a large vein on them if you removed all their skin and could see inside them. Some drugs you can dilute with lots of saline and still be safe. Other times you may have to call the doc and tell him that you can't give the drug with the available IV site, you are unable to get a better site, and please consider a PICC or TLC.

a midline or picc line would be your larger veins.

but even w/a midline or peripheral, i dilute like crazy and push very, very slowly.

(i never use hand veins)

leslie