Intravenous therapy is the method by which a catheter is inserted into a vein, with a needle, to deliver fluid directly into the bloodstream. The most common intravenous sites are located on the top of the hand, the lower forearm, or the upper, inner forearm near the fold of the elbow. On occasion, the large jugular vein in the neck, or some in the foot, may be considered. A vein in the scalp is most frequently used as an intravenous site for infants.
Veins in the upper forearm and hand are typically ideal intravenous sites. The easier it is for the medical professional to locate the site, the better the chance that the first needle stick will be successful. The cephalic vein is generally the most accessible. It is located along the side of the wrist nearest the thumb, and runs along a slight angle up the arm, toward the body.
Other common sites in the arm include the basilic vein and median cubital vein. Movement may be a little more difficult on the patient when these sites are used. They are located near the inside bend of the elbow, which can limit the patient's flexibility, and some people find it uncomfortable.
There are several reasons why a medical professional may choose not to use the hand or arm for intravenous therapy. An example of such instance might be when the patient has swelling or an injury, such as burns or fractures, in the upper extremities. Another reason could be that the sites may have been compromised by multiple needle sticks.
When intravenous therapy in the hand or arm is not appropriate, the external jugular vein can be used. It is much larger than other commonly used intravenous sites. Located on the side of the neck, it runs vertically from the top of the jaw line, close to the ear, toward the clavicle bone leading to the shoulder. When a patient has poor access sites in the arm, or when large amounts of fluid need to be injected, the jugular vein may be used.
While not ideal, there are some instances where it is necessary to use a vein in the foot. This is not done often, because it is often more painful for the patient. Blood does not flow as freely in this area and therefore the method can be less effective. There can also be an increased risk of infection, so medical professionals do not regularly elect placement in this region unless it is necessary.
Newborn infants sometimes require intravenous therapy. A vein in the baby's hand, arm, or foot can be used, although it is more difficult to insert and keep in place. Some babies may also dislodge it. For this reason, a vein in the scalp of a newborn can usually be used as an effective and safe intravenous site.
