What is Intravenous Access?

Intravenous Access or Intravenous Therapy is a procedure utilized for directly administering fluid into a vein. Available for both injection and infusion purposes, it is most commonly used for fluid administering system. It helps to prohibit a multitude of complications like septicity, unsanitary infections and excessive loss of blood, amongst other things. The primary benefits of using an IV Access can be concluded to few essential points – ease of access, quick administration, fast results, ease in monitoring, complete elimination of adverse side effects, visibility, resilience, efficiency, safety, cleanliness, and portability.

What are the various types of IV Access?

Categorized according to the type of veins the tube is inserted into, IV Access types can be divided in the following variations:

Peripheral Lines:

The most common variety of IV Access Devices are administered in the peripheral veins, i.e. arms, hand, legs, and feet.

Central Venous Lines:

IV Cannulation procedures that go through a general secondary/tertiary vein and vacates into a sizeable primary vein (e.g. Abdominal veins, Atrium veins, Vertebral veins).

Peripherally Inserted Central Catheters (PICC):

An IV Access Port administered through a peripheral vein, this is a more complicated procedure that involves using the modified or general Seldinger Technique with ultrasound guidance before the IV Cannulation equipment s drained into the superior vena cava or the right atrium. In case of not opting for fluoroscopy, an X-Ray should be used to ensure proper placement of the catheter tip. Available in single lumen, double lumen, and triple lumen connector versions, PICC tends to be a bit thicker than the usual Peripheral Lines.

Tunneled Lines:

Unlike the general catheters that pass through the skin and gets directly connected to a vein, Tunneled IV Cannulation Equipment travels through the skin into a “tunnel” (a hollow place covering a significant distance) before being inserted into a vein. The benefits of using this type of IV equipment include a substantial reduction in the risk of contracting an infection and blood clots, especially in Peripheral IV sites in case the patient is prone to skin and blood complications.

Midline Catheter:

This type of IV Lines can be deemed as an amalgamation of General Peripheral lines and a PICC – the twist being, though it travels through a vein deeper into the body, the tips are administered just a few inches before the start of a Central Vein.

What are the variations of IV Access Infusions?

IV Access infusions are categorized into the following types and purposes:

  • Continuous Infusion – Used to balance out fluids and electrolytes (as opposed to medicated intermittent injections).
  • Secondary IV Infusions – Any IV infusion that is added to the first pack of fluid being administered to a patient is called Secondary (piggyback) IV Infusion. The secondary infusion bag is generally placed higher than the primary bag so that the latter is infused with the previous line of medication before traveling into the patient’s vein.
  • IV Push – Medications/fluids administered directly but slowly into an access port either attached directly to the patient’s vein or into the primary infusion tubing is called an IV push or bolus. A patient’s vein can be flushed of any remnants of blood clots with the same procedure. The following types of agents act as the main components of an IV infusion:
  • Volume Expanders: The volume expanders consist of two main variations -crystalloids and colloids, generally including soluble materials like saline, blood, albumin, and plasma, among other things. There are three primary pressured volumes available for this type of infusions i.e. isotonic (general osmotic pressure), hypotonic (lower osmotic pressure) and hypertonic (higher osmotic pressure).
  • Medications: Generally used with a mix of volume expanders, medicines like antibiotics, intravenous immunoglobin and propofol is administered through IV for having a faster, more direct and long-lasting effect in the bloodstream. Pills dissolve at a percentage of 20%-30% due to the presence of digestive acids when taken orally, as compared to IV where it is effective at a given 100%.
  • Blood-Based Products: A product consisting of components contributing to the anatomy of human blood, i.e. plasma, blood cells, cryoprecipitates are more commonly known as blood infusions. Blood substitutes or blood surrogates that provide a substitution to the said components are other variations of Blood-based products.
  • Buffer Solution: Fluids used to rectify acidosis or alkalosis are called Buffer Solutions.
  • Nutrition: Components used to feed a person intravenously omitting the regular eating and digesting process is called parenteral or enteral food. The solution usually consists of various mineral salts, glucose, amino acids, lipids, proteins, and vitamins, and is available in a variety of flavors.

What are the types of equipment used in IV Access?

An IV administration module consists of a set of sterilized equipment – a fluid container (glass/plastic bottle or plastic bag), a controllable dripper attached to a tube, an attachment to connect any access device, and a Y-set to induce secondary infusions;

Infusion Pumps:

An infusion pump allows the user to control the flow rate and delivering the amount of the fluid. The VTBI (Volume to Be Infused) is generally maintained at 50 milliliters or lower than what’s stated on the IV bag – this stops the IV Tube or lining from turning dry.

Hypodermic Needle:

The first part of administering an IV device is passing a hollow needle directly into the vein through the dermal layers. The rear part of the needle, in turn, is connected to a syringe or tubing which is connected to the infusion system of choice. A tourniquet is generally used to help with the bulging of the vein and preventing any venous drainage from the limbs.

Drip Chamber: 

This is a drip controlling tool that is used in the majority of IV systems to prevent air bubbles from entering the bloodstream. The drip chamber also allows the correct estimation of the infusion flow rate.

Peripheral Cannula:

The Cannula consists of one of the IV Catheters mentioned above, i.e. Peripheral Lines, Central Venous Lines, Peripherally Inserted Central Catheters, Tunneled Lines & Midline Catheters.

Pressure Bags: 

This is an inflatable cup or an electric device that is placed on or around the fluid bag to induce rapid flow infusion in patients requiring highly pressured drips; it can also be used to heat the fluid before being administered directly into the vein.

What are the required measures to be kept in mind during an IV Access administration?

IV Access, being one of the most popular mediums to administer fluids or liquids, can be complicated when it comes to specific terms. One should keep such complications in mind in regard to previous/ongoing health factors such as Renal Failures, Pain Threshold, Skin Infections, Thrombosis, Phlebitis, Fluid Overload, Embolism, Glucose Imbalance, Electrolyte Imbalance, Hypothermia, Congenital Heart Diseases or Single Ventricular Physiology; not to mention the general drawbacks of improper cannulation i.e. Blockage of line, Dislodgement or Damage of the Port or Line, Accidental Arterial Cannulation, Injuries related to Extravasation and Needle placement, and Obviously, an Unsuccessful procedure. Proper Supervision and the presence of necessary precautions are advised.

Here’s an assortment of First-grade IV Access Equipment to help you with the monumental line of projects ahead.