In this section
Definition of terms
Peripheral intravenous catheters (PIVCs) are the most commonly used intravenous devices in hospitalised paediatric patients. They are primarily used for therapeutic purposes such as administration of medications, fluids, and blood products.
by The Royal Children's Hospital, Melbourne
The aim of this guideline is to provide an outline of the ongoing maintenance and management of the PIVC for patients in hospital, outpatient, and home healthcare settings. For information related to insertion of PIVC, please refer to intravenous access guideline (https://www.rch.org.au/clinicalguide/guideline_index/Intravenous_access_Peripheral/). Nurses who are deemed competent in IV insertion could continue to insert PIVC in consultation with NUM/CSN’s.
Patient and IV site assessments should be done on a regular basis.
PIVC assessment includes:
Administration of intravenous fluid, drug infusions or blood products
Pressure limit defaults for intravascular infusion pumps are programmed by Biomedical Engineering, based on the manufacturer’s recommendations.
Upper limit infusion pump pressure can be manually increased with clinical discretion to accommodate:
If pump pressure exceeds the recommended limits, check the patency of the PIVC.
Special consideration: Patients admitted to the Neonatal Unit should have line pressure documented within the Peripheral IV Cannula Lines, Drains, and Airway (LDA) tab.
Drugs administered via PIVC may be
The most appropriate method should be selected depending on volume of diluent required, patient condition, fluid balance and intended rate of delivery.
Which Fluids and how much fluids to use
Refer to the Intravenous Fluids Clinical Practice Guideline:
Table 1.Changing IV bags and lines
There is no evidence for routine
replacement of PIVC unless clinically indicated. PIVC’s should be maintained
with regular assessment and documentation of complications.
The possible reasons for removal of PIVC’s
include a number of complications which range from infiltration, extravasation,
phlebitis, occlusion, dislodgement and migration. Once the child’s treatment is
over, the PIVC should be removed to avoid any additional complications.
There are a
range of complications that could occur with the presence of a PIVC in situ.
Some of these complications can be prevented by the correct use of aseptic
technique for insertion and maintenance as well as assessing the device as
For assistance with difficult intravenous access
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Anaesthetics ASCOM 52000
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The evidence table can be found here.
Please remember to read the
The development of this nursing guideline was coordinated by Eloise Borello, CNC Quality & Improvement, and Lauren Nichols, CSN PICU, approved by the Nursing Clinical Effectiveness Committee. Updated December 2022.