While you may not feel a palpable cord or any erythema, inflammation or warmth along the vein pathway, pain and discomfort can be an early sign of phlebitis or even a very early infiltration. One thing you left out is how long had the line been in place and what had been infusing through it.Those pieces of information are useful in making the best decision for your patient.With only the information you provided me if I chose to leave the PIV in I would up my assessment frequency.If it is indeed "going bad" it will only get worse with time and that will soon be apparent. If ,however, it is a fairly new line,the medications and/or fluids are not irritating and the patient tends to be hypersensitive it may still be good.Keep in mind the average PIV has a dwell time of 44 hours before it becomes symptomatic...I said average now and have seen many PIVs last longer, but it's helpful to know that.The odds are it's on the way out.11 venipunctures in 3 days is not as bad as it may seem because it is all relative to the benefit the patient is going to receive by getting his IV antibiotics or other IV therapies. But you are correct in assessing the availability of the peripheral veins and then determining if they can sustain the currently prescribed IV therapies and if not some other type of access needs to be obtained...Midline,PICC or other type of CVAD...perhaps an EJ if there is a short term need
