Peripheral IV

For as long as I have been an infusion nurse, I have always used heat to help me find a suitable vein for peripheral venipuncture. The application of heat to the patient’s skin during vein assessment has been very helpful in my practice and prior to insertion has contributed to my “one stick” success. As a nurse, I knew that heat increases blood flow allowing for good venous dilatation, thus improved vein visualization. I have used either the warm blankets from our warming cabinet or the dry chemical instant “warm packs” as my warming methods. I stayed away from moist heat especially wet towels heated in the microwave. I feared that its use might cause burn or irritation to the patient’s skin. This anecdotal “theory” is based on over 20 years of IV experience and practice. I would guarantee that many other nurses would agree, but yes, it hasn’t been studied and we need evidence based research to validate my anecdotal theory.

To my delight, a research article was recently published in the Oncology Nursing Forum about a study to determine whether dry vs. moist heat application improves IV insertion rates. The findings of the article “The Impact of Dry versus Moist Heat on Peripheral IV Catheter Insertion in a Hematology-Oncology Outpatient Population” that dry heat was 2.7 times more likely than moist heat to result in successful IV insertion on the first attempt, had significantly lower insertion times, and was more comfortable. Heat type had no effect on patient anxiety. The authors concluded that dry heat application decreases the likelihood of multiple IV insertion attempts and procedure time and is comfortable, safe, and economical to use in an outpatient oncology setting. Certainly, there are limitations to this study and more studies are needed but this has provided the evidence we need to incorporate the use of dry heat in policies and procedures as a means to improve the success of IV insertion on the first attempt.