Peripheral IV Catheter Chart

External Water
Gauge Length Recommended
Color Diameter Flow Rate
Size (mm)* Uses
(mm)* (mL/min)*

Trauma, Rapid
~240 blood
14G 2.1 mm 45 mm
mL/min transfusion,
Surgery1
Orange

Rapid fluid
replacement,
~180
16G 1.8 mm 45 mm Trauma, Rapid
mL/min
blood
transfusion1
Gray

Rapid fluid
replacement,
~90
18G 1.3 mm 32 mm Trauma, Rapid
mL/min
blood
transfusion1
Green

Most infusions,
Rapid fluid
~60 replacement,
20G 1.1 mm 32 mm
mL/min Trauma,
Routine blood
Pink transfusion1

Most infusions,
Neonate,
~36 Pediatric, Older
22G 0.9 mm 25 mm
mL/min adults, Routine
blood
Blue transfusion1
 Most infusions,
Neonate,
Pediatric, Older
adults, Routine
~20
24G 0.7 mm 19 mm blood
mL/min
transfusion,
Neonate or
Yellow
Pediatric blood
transfusion1

~13 Pediatrics,
26G 0.6 mm 19 mm
mL/min Neonate1

Purple

References: Infusion Therapy Standards of Practice Jan/Feb 20161

https://www.bd.com/infusion/products/ivcatheters/iagbc/videos/pdfs/iagbc_wp3.pdf 2
*varies by specific catheter and manufacturer
Blood Type Compatibility
o Group A – has only the A antigen on red cells (and B antibody in the plasma). Group A can donate
red blood cells to A’s and AB’s
o Group B – has only the B antigen on red cells (and A antibody in the plasma). Group B can donate
red blood cells to B’s and AB’s.
o Group AB – has both A and B antigens on red cells (but neither A nor B antibody in the plasma).
Group AB can donate red blood cells to other AB’s, but can receive from all others. Group AB is the
universal plasma donor.
o Group O – has neither A nor B antigens on red cells (but both A and B antibody are in the plasma).
Group O can donate red blood cells to anybody. It is the universal red cell donor.

O- O+ B- B+ A- A+ AB- AB+

AB
+

AB-

A+

A-

B+

B-

O+

O-
IV
TUBING
20 25 30 50 60 70 75 80 100 110 120 125 130 150 175 200
DROP
FACTOR

DROPS PER MINUTE

10
3 4 5 8 10 11 12 13 16 18 20 21 22 25 30 34
DROP/MIL

15
5 6 7 12 15 17 18 20 25 27 30 31 32 38 44 50
DROP/MIL

20
6 8 10 16 20 22 24 26 32 36 40 42 44 50 60 68
DROP/MIL

60
20 25 30 50 60 70 75 80 100 110 120 125 130 150 175 200
DROP/MIL

o Volume of fluid to be infused

Information necessary to calculate IV flow rate: o Total infusion time
o Drop Factor = Calibration of the administration set used (number
Volume to be Infused (ml) / Total Infusion Time (hours) of drops per milliliter the tubing delivers; this information is found
= Hourly IV Rate on the tubing package)
 ABCD Approach for Evaluation and Treatment of
Contrast Reactions

Airway, Oxygen

Assessment (severity and category of reaction); blood pressure and pulse (necessary);
electrocardiogram monitor may be necessary for evaluation of cardiac rhythm

Assistance (call for it)

Access (venous)-secure/improve intravenous line(s) – peripheral or central

A
Breathing (begin cardiopulmonary resuscitation [CPR] if necessary); use mouth protective
barrier

Bag-valve-mask (e.g., “Ambu” bag) or mouth-mask

Begin full resuscitation efforts (CPR) if necessary; call cardiopulmonary arrest response
team
B
Beware of atypical manifestation (e.g., beta-blockers may prevent tachycardic response)

Circulatory assistance: as appropriate, administer isotonic fluid (e.g., Ringer’s lactate,

normal saline), infuse rapidly, and may use pressure bag or forceful infusion

Categorize reaction and patient status, Call cardiopulmonary arrest response team if
necessary; CPR; continue to monitor

Common denominators: assess cardiac output; capillary leak (third spacing); decreased
venous return, decreased peripheral vascular resistance; pulmonary edema
C
Drug therapies as appropriate

Do: monitor, assess, and reassure the patient; use correct dose (concentration) and route
for drugs; push intravenous fluids and oxygen

Don’t delay (call for help, if you need it); don’t use incorrect dose(s) and drugs
D
 Acute Contrast Reaction Management

o Discontinue injection if not completed

o No treatment needed in most cases - reassure the patient
o Consider diphenhydramine (Benadryl®) PO/IM/IV 25-50
Hives (uticaria) mg
o If severe/widely disseminated: Epinephrine SC (1:1,000)
0.1-0.3 ml (=0.1-0.3 mg) (if no cardiac contraindications)

o 0.1-0.3 ml epinephrine SC or IM (1:1,000) (=0.1-0.3 mg)

or, if hypotensive, 1 ml epinephrine IV (1:10,000) slowly
(=0.1 mg). Repeat as needed up to 1 mg.
Facial or Laryngeal o Give oxygen 6-10 L/min (via mask)
Edema o If not responsive to therapy or if there is obvious acute
laryngeal edema, seek appropriate assistance (e.g.,
cardiopulmonary arrest response team).

o Give oxygen 6-10 L/min (via mask)

o Monitor: ECG, O2 saturation (pulse oximeter), and BP
o Give beta-agonist inhalers, such as metaproterenol
(Alupent®), terbutaline (Brethaire®), or albuterol
(Proventil®)(Ventolin®) 2-3 puffs; repeat as needed
o If unresponsive, epinephrine SC or IM (1:1,000) 0.1-0.3
ml (=0.1-0.3 mg) or, if hypotensive, epinephrine
Bronchospasm
(1:10,000) slowly IV 1 ml (=0.1 mg) - Repeat up to 1 mg
o Alternatively, give aminophylline 6 mg/kg IV in D5W
over 10-20 minutes (loading dose), then 0.4-1 mg/kg/hr, as
needed (caution: hypotension)
o Call for assistance for severe bronchospasm or if O2
saturation < 88% persists

o Legs elevated 60° or more (preferred) or Trendelenburg

position
o Monitor: ECG, O2 saturation (pulse oximeter), and BP
o Give oxygen 6-10 L/min (via mask)
Hypotension with o Rapid large volumes of IV isotonic Ringer’s lactate or
Tachycardia normal saline
o If poorly responsive: Epinephrine (1:10,000) slowly IV 1
ml (=0.1 mg) (if no cardiac contraindications). Repeat as
needed up to a maximum of 1 mg
o If still poorly responsive seek appropriate assistance (e.g.,
 arrest team).

o Monitor: ECG, O2 saturation (pulse oximeter), and BP

o Legs elevated 60° or more (preferred) or Trendelenburg
position
o Secure airway and give oxygen 6-10 L/min (via mask)
Hypotension with o Rapid large volumes of IV isotonic Ringer’s lactate or
Bradycardia (Vagal normal saline
Reaction) o If unresponsive, atropine 0.6-1 mg IV slowly - repeat up to
2-3 mg in adult
o Ensure complete resolution of hypotension and
bradycardia prior to discharge.

o Give oxygen 6-10 L/min (via mask)

o Monitor: ECG, O2 saturation (pulse oximeter), and BP
o Give nitroglycerine 0.4-mg tablet, sublingual (may repeat
Severe Hypertension x 3)
o Transfer to intensive care unit or emergency department
o For pheochromocytoma—phentolamine 5 mg IV

o May be consequence of hypotension, primary treatment

should be as indicated
o Lateral decubitus position, give oxygen, 6-10 L/min by
mask
o Consider diazepam (Valium®) 5 mg or more or
midazolam (Versed®) 0.5-1 mg IV
o If longer effect needed, obtain consultation; consider
Seizures or Convulsions
phenytoin (Dilantin®) infusion – 15-18 mg/kg at 50
mg/min.
o Careful monitoring of vital signs, particularly of pO2
(respiratory depression)
o Consider using cardiopulmonary arrest response team for
intubation

o Elevate torso; rotating tourniquets (venous compression)

o Give O2 6-10 liters/min (via mask)
o Give diuretics – furosemide (Lasix®) 20-40 mg IV, slow
Pulmonary Edema
push
o Consider giving morphine (1-3 mg IV)
o Transfer to intensive care unit or emergency department
 o Corticosteroids optional

o CALL CODE
o Institute Basic Life Support
Unconscious,
Unresponsive, Pulseless, 1. Establish airway, head tilt, chin lift
or Collapsed Patient 2. Initiate ventilation and external chest compression
3. Continue uninterrupted until help arrives

References
1. Manual on Contrast Media, Version 10.2, 2016. American College of
Radiology. http://www.acr.org/~/media/ACR/Documents/PDF/QualitySafety/Resources/Contrast%20Manua
l/2016_Contrast_Media.pdf

2. CT and X-ray Contrast Guidelines, UCSF Department of Radiology and Biomedical Imaging; Management
of Acute Contrast Reactions; accessed 10/24/2016 https://radiology.ucsf.edu/patient-care/patient-
safety/contrast/iodinated#accordion-allergies
 Administration Set
Change Chart

Administration Administra
Set Change Frequency
Type tion Set

If infusate is administered
continuously via primary or secondary
administration set, including add-on
Primary and Secondary devices, change set(s) no more
Continuous Infusions Primary Set frequently than at 96 hour intervals,
1
but at least every 7 days.
(Infusions NOT containing Secondary
blood, blood products or "piggyback" set
Primary and secondary continuous
intravenous fat emulsions)
administration sets should be changed
no more frequently than every 96
2
hours.

Primary Intermittent No frequency recommendation.

Infusions 1
Unresolved issue.
Primary Set
(Infusions NOT containing
blood, blood products or 2
Replace set every 24 hours.
Intravenous fat emulsions)

Intravenous Fat Emulsion Primary Set Within 24 hours of initiating the

(IVFE) 1
infusion.
Secondary
Use DEHP free tubing "piggyback" set If infused separately, replace every 12
hours and/or with the with each new
2
container.

TPN containing IVFE

Replace every 24 hours and/or with
Primary Set 2
(3 in 1 formula) the with each new container.
Use DEHP free tubing

1
No recommendation
TPN (without IVFE) Primary Set
Replace at least every 24 hours and
2
with each new TPN/PN container.

Replace within 24 hours of initiating

1
the infusion.
Primary Set
Blood / Blood Products
Replace administration set and filter
Filter
after the completion of each unit or
2
every 4 hours.

Replace every 6 or 12 hours, when the

vial is changed, per the manufacturer's
1
recommendation.
Propofol Primary Set
Replace every 6-12 hours per
manufacturer instructions or when the
2
container is changed
 Site Observation Score Stage/Action

IV site appears healthy No signs of phlebitis

0
OBSERVE CANNULA

One of the following signs is evident:

o Slight pain near the IV site OR Possibly first signs of phlebitis

1
o Slight redness near IV site OBSERVE CANNULA

TWO of the following are evident:

o Pain at IV site Early stage of phlebitis

2
o Redness RESITE CANNULA

ALL of the following are evident:

o Pain along path of cannula Medium stage of phlebitis

o Redness around site 3 RESITE CANNULA
o Swelling CONSIDER TREATMENT

ALL of the following signs are

Advanced stage of phlebitis
evident and extensive:
Or the start of thrombophlebitis
4
RESITE CANNULA
o Pain along path of cannula
CONSIDER TREATMENT
o Redness around site
o Swelling
o Palpable venous cord

ALL of the following signs are

evident and extensive:

o Pain along path of cannula Advanced stage

o Redness around site thrombophlebitis
5
o Swelling INITIATE TREATMENT
o Palpable venous cord RESITE CANNULA
o Pyrexia