PIV Catheter Gauge selection

The goal when selecting the proper gauge of an peripheral IV catheter is to ensure that the best device meets the patient’s needs.  This means taking into consideration many factors such as:

  • Prescribed therapy/type of solution
  • Duration of treatment
  • Peripheral vein availability/vein integrity
  • Diagnosis /Age
  • Known complications of the device

The Infusion Nurses Society standards of practice states “the smallest gauge and length with the fewest number of lumens and shall be the least invasive device needed to accommodate and manage the prescribed therapy.”  A small gauge catheter results in less trauma to the vein, promotes proper hemodilution of the solution, and allows adequate blood flow around the catheter wall. All these factors promote increased catheter dwell time and improve patient outcomes.

The recommendation for catheter selection from the textbook “Infusion Nursing: An Evidence based Approach” include the following:

Catheter Size (Gauge) /Clinical Applications

24g – Fragile veins; for intermittent and continuous infusions

22g – Children/Older adults; intermittent general infusions

20g – Adults/continuous infusions

14g, 16g, 18g –  Trauma and surgery

It is important to note that for transfusions of blood or blood products, 14-24g can be used for adults and 22g-24g for pediatrics and neonates.

In an emergency situation where rapid infusion of large amounts of fluids are necessary, a larger gauge catheter may be used. Catheters inserted in emergency situations should be removed and replaced as soon as the patient is stabilized, but within 24 hours of the emergency as one cannot ensure that the site was adequately prepped or that aseptic technique was maintained.

So now you know….size matters but bigger isn’t always better!!

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2 thoughts on “PIV Catheter Gauge selection

  1. Thank you for the up-date. I have made a small change in my practice that has helped me have more success in placing 22’s or 20’s in my elderly patients. I do not use a touriquet on these patients as I find the veins bruise very easily. I just try and anchor the vein with my left hand as I am a right handed nurse, and very slowly place the catheter and wait for the slow blood return in to the cartridge.. It avoids having to stick the patient a second time. It also helps if I explain to the patient what I am doing about inserting the catheter more slowly, They are a little more accepting of the catheter being placed.

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