The intravenous administration of medication is one of the most common clinical practices in any hospital, to the point where the insertion of a catheter (“to insert an I.V.”) for this purpose is common in admitted patients, either on a scheduled basis or through the emergency area.
The intravenous route has many advantages over the oral route if the patient needs to rapidly acquire a concentration of the drug with therapeutic effects; if the drug does not pass through the gastrointestinal tract, the time required to reach that effect will be much less. In addition, there are many drugs that cannot be administered by any other routes, as they would be destroyed by the gastrointestinal acids and enzymes.
From the technological point of view, there has been a lot of progress made, from the classic “drippers” that are manually controlled, where adjusting the dose to be infused was complex and imprecise, to the current TCI infusion pumps that include pharmacokinetic models able to adjust the flow automatically according to the dosage prescribed by the doctor, the type of drug and the patient’s physical parameters (age, weight, height, etc.).
Although certain therapies or diagnostic tests (e.g., gasometry or catheterization in the hemodynamics room) use arterial lines, the intravenous line is the most commonly used for drug infusion.
Central and peripheral lines
There are two main types of intravenous lines: central and peripheral lines, these being the most commonly used.
A central line is a line inserted into a vein that communicates directly with the heart’s right atrium. To do this, a catheter is inserted into one of the largest caliber veins (usually the femoral vein, the subclavian or the internal jugular vein). Due to the high blood flow on these veins, this type of line allows for the infusion of a larger quantity of the drug (or several drugs at the same time, even incompatible drugs without precipitation risks), in addition to being the right choice when administering treatments that could damage the smaller peripheral vessels, either due of their high osmolarity, increased protein concentration or other relevant factors.
A peripheral line is inserted into a small caliber superficial vein in one of the extremities. The veins used in the upper extremities include the cephalic, basilica and brachial veins at the elbow, the veins in the forearm and those on the back of the hand. In order to choose one or the other, the following is taken into account: the caliber of the veins, the type of medication and, to the extent possible, the patient’s comfort and mobility.
In the lower extremities, the saphenous or pedis vein are usually used. These veins, along with the veins in the scalp, are often used when there are problems associated with using the upper extremities, and in babies and newborns, due to the small caliber of the veins of the arm or forearm.
Each type of line requires specific material in terms of gauge and type of catheter to be used. In addition, certain treatments, especially in oncology, require systems developed with material specifically for this purpose.
At arcomed we have an extensive catalog of materials for intravenous infusion in all types of lines, which are the perfect counterpart to our infusion pumps and are manufactured with the same highest quality controls in terms of materials and respect for the environment, both during their manufacture and when being destroyed. Check out our website or ask us for more information and discover arcomed’s universe of possibilities.