Size of Angiocath for IV

fergus51 · Jul 8, 2006

Every unit I've been on had 18s as the standards and we were allowed to use 20s if needed. I really don't think the size of the cath makes a huge difference, but that's me.

rpbear · Jul 8, 2006

We use 18g. We have anesthesia start the IV if even our best IV starters can't get it.

skipaway · Jul 8, 2006

I think 18g IVs should be the standard. Yes, you can run blood through a 20g, but when hemorrhaging occurs, you need an IV that you can rapidly run the blood through. Review Poiseule's Law of Physics regarding flow rates and pressure.

ragingmomster, BSN, MSN, RN · Jul 8, 2006

18's for us, we will drop back to a 20 when we really have to. Anaesthesia is our back up if we need a larger bore for blood.

Not to side track, a related question.

I am wondering if gauge r/t color of hub is standardized. We get transfers in daily and without documentation of what kind of IV the pt has we have to guess to ourselves and document only what we can see.

Our 18's are green and 20's are pink. Anyone else?

skipaway · Jul 8, 2006

I am wondering if gauge r/t color of hub is standardized. We get transfers in daily and without documentation of what kind of IV the pt has we have to guess to ourselves and document only what we can see.
Our 18's are green and 20's are pink. Anyone else?

Yes, ours in NC, are also green (18g), pink (20g), gray (16g). I believe they are standardized.

nurseob7 · Jul 8, 2006

18 G are green -- 20 g Pink --- 22 g Blue

I just find we rarely give blood anymore ---- delivering about 2,000 babies a year. In the last few years, I've given blood twice and that was the day after birth (not a true emergency situation) A few nurses on my unit just feel that if we start putting 20's in everyone routinely, our pts would be happier and a successful first stick would be increased. Blood can always be started with the 20 g angiocath and if you need to have a bigger one for faster infusion, why not start an 18 at that time?

Of course, you could say that in a true emergency, time is precious, and what if you are unable to get an 18 in at that time? How about a pump for the blood to increase the rate? We usually use free flow tubing for IV solutions and blood. The anesthesiologist would normally be present during surgery of course and could do a second line .......

My unit wants to improve nursing care to reflect evidence based practice. I'd appreciate your input. Thanks!

KR · Jul 8, 2006

ICU RN here. Have never done L and D. But saw the post, wanted to put in my two cents worth. Routinely blood is given through an #18g IV. However, if push comes to shove they can use a #20g, but definately would not infuse through at #22g. Besides the blood not being able to run at a decent rate, you also risk hemolyzing the blood and then it is pretty much worthless.

SmilingBluEyes · Jul 9, 2006

We are asked/required to use 18G for all OB pts requiring IV/saline lock. In some very tough sticks, who blow easily, I have been known to use a 20g however. Anesthesia would prefer we used 16g but nobody does where I am.

SmilingBluEyes · Jul 9, 2006

ICU nurse is right; you can infuse blood in a 20g----push to shove. But you are best off starting w/an 18g if you can do it!

tdr61 · Jul 10, 2006

18g is what I use, if it's a really tough stick and anesthesia isn't able to attempt a start I will use a 20g. I did work at a hospital a few years back that required 2 IV's, one of which had to be a 16g if a patient was going for a c-section (scheduled or unscheduled). A little overkill I thought.

Binkey, BSN · Jul 10, 2006

The important thing to remember here is whether or not this is a pt on a med-surg floor, or a pt in a LTC facility vs. a pt who is in the field (just having a MVA) or ER or OB. In an emergency, yes, the larger bore IV catheters are the best, however, if the pt is stable, always choose the smallest gauge and length possible for the prescribed therapy. This is an INS (Infusion Nuses Society) standard and one that clinicians should follow. In the case of blood transfusions, I always use a 22g for my elderly pt's, as long as I can give that unit over 3-4hours. It Does NOT lyse the cells, unless I'm running it real fast, or it's under a great deal of pressure.

By choosing the smallest gauge, you are allowing for a better blood flow around the IV catheter and a better hemodilution of the med. This decreases the damage to the Tunica Intima.

DD