Peripheral IVs

[NurseyPoo7]

If a patient has an IV inserted in the area located above the crease of the axilla, between the shoulder/chest, is that even considered a peripheral IV?

How would one determine if it was infiltrated, especially in an obese patient?

Also, would you need an MD order to an IV placed in this area , for a Med Surg floor and not in emergency situations?

[MN-Nurse, ASN, RN]

If a patient has an IV inserted in the area located above the crease of the axilla, between the shoulder/chest, is that even considered a peripheral IV?

How would one determine if it was infiltrated, especially in an obese patient?

Also, would you need an MD order to an IV placed in this area , for a Med Surg floor and not in emergency situations?

Peripheral vs Central is determined by where they terminate.

You determine the IV is infiltrated the same way as non-obese patients.

We have standing orders that say, "Insert and maintain peripheral IV."

[beckster_01, BSN, RN]

If it is a peripheral vessel, it is a peripheral IV :)

Monitor it just as you would any other PIV. If it is infiltrated you would still see signs of inflammation, pain, etc. I have seen IV's placed in this spot by our IV service. The only PIV I have seen an MD place are external jugular IV's. Of course, I am sure that is largely subject to hospital policy.

[DookieMeisterRN]

Do you not get any kind of training with your IV team or are you still in nursing school. It's usually fairly easy to differentiate from a central line not because of the location necessarily but how the catheter looks, where it terminates and of course you can see what the previous documentation says. I've seen PIV's in external jugulars but never in the place you've mentioned. Of course that doesn't mean it can't be done.

The best way to learn you're PIV's and central lines is to pick the brains of your PICC nurse, they usually love to teach and can show you lots of interesting things.

[erhnurse]

in my facility you have to have an order to place a peripheral iv cath in a leg/foot only. and thats only because of possible circulation issues...just bc the vein you choose to place the cath in is on the pt's chest does not mean it is inserting directly into their heart. an infiltrated iv on an overweight person will be painful and swollen just like an emaciated person.

[IVRUS, BSN, RN]

Disagree... A PICC is inserted into a peripheral vessel in the arm, but IT IS NOT considered a peripheral IV catheter, but rather a CENTRAL CATHETER as its tip terminates in the central vasculature.