News | August 10, 1999

I.V. Q & A: Choosing a Site

Editor's Note: Have questions about infusion therapy? I.V. Q and A is the place to look for answers. Check back weekly for a new question related to the placement, use, and maintenance of I.V.s.

My question refers to choosing an IV site. If you have a patient who does not have any accessible sites in the upper extremities, what are the pros and/or cons to insertion of a peripheral catheter in the lower extremities?

I can't think of any ‘pros' for maintaining a catheter site in the lower extremities. The ‘cons' are the following: deep vein thrombosis, phlebitis, thrombophlebitis, infiltration/extravasation, decreased ambulation, and possible catheter fracture with embolization. With those complications comes the risk of amputation secondary to compromised circulation, with possible loss of income or even life over the treatment period, not to mention possible litigation. Please check the Intravenous Nursing Standards of Practice (revised 1998), number 49, Site Selection, Standard I with Interpretation. References are cited at the end of the section. Standards of Practice may also be found on the INS Web site at I also suggest conducting a literature search for further research and documentation on this subject.

Reprinted with permission from the INS Newsline, Intravenous Nurses Society, Cambridge, MA; These questions come from I.V. clinicians and are answered by Debbie Benvenuto, CRNI, INS Nurse Educator/IV Therapy and coordinator of the INS National IV Nursing Network.

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