A Peripheral IV (PIV), or Peripheral Intravenous Cannula, is a small, flexible catheter inserted into a peripheral vein—typically in the hand, arm, or forearm—for the purpose of delivering fluids, medications, or nutrients directly into the bloodstream. It is the most common form of venous access used in both emergency and routine hospital care due to its relative simplicity, safety, and speed of insertion. Peripheral IVs are essential for short-term intravenous therapy and are widely used in hospitals, clinics, and ambulatory settings.

Pharmaceutical Properties:
While a Peripheral IV is a medical procedure rather than a pharmaceutical agent, it is a route of administration. The cannula itself is made of medical-grade, sterile, biocompatible materials (typically polyurethane or Teflon) and is designed to minimize irritation and infection. The device comes in various sizes (gauges), typically ranging from 14G (large bore for trauma) to 24G (for pediatric or fragile veins).

The IV line allows for the infusion of:

• Crystalloids (e.g., Normal Saline, Lactated Ringer’s)

• Colloids (e.g., albumin)

• Medications (antibiotics, analgesics, sedatives, etc.)

• Blood products (when required urgently)

Indications for Use:

• Fluid Resuscitation: In cases of dehydration, blood loss, or shock.

• Medication Administration: Rapid delivery of antibiotics, analgesics, or emergency drugs.

• Blood Sampling: For quick blood draws when frequent testing is needed.

• Nutritional Support: Temporary infusion of parenteral nutrition or glucose.

• Preoperative Preparation: Establishing venous access for anesthesia or intraoperative needs.

• Emergency Care: Rapid venous access in trauma or cardiac arrest.

Mechanism of Action:
A Peripheral IV functions by allowing direct access to the peripheral venous system. Once inserted, fluids or medications bypass the digestive system and enter the circulation almost immediately, resulting in faster onset of action. This route ensures precise control over dosage and absorption, crucial in emergency and critical care settings.

When fluids or drugs are administered through the PIV, they mix with circulating blood and are distributed throughout the body. The vein wall’s smooth endothelium facilitates easy flow, while the cannula ensures stability and access over a period of hours to several days (typically up to 72–96 hours).

Clinical Protocol in Dubai:
In Dubai, peripheral IV insertion and management are performed according to the guidelines set by the Dubai Health Authority (DHA). These protocols ensure safe, sterile, and efficient insertion, minimizing the risk of infection, infiltration, or thrombophlebitis.

1. Insertion Procedure:

   • Patient Preparation: Obtain consent, assess patient history, and choose the appropriate vein.

   • Aseptic Technique: Hand hygiene, gloves, antiseptic cleansing of the insertion site.

   • Insertion: Use the appropriate gauge cannula (18G–22G most commonly), insert into the vein at a shallow angle, confirm blood return, and secure with sterile dressing.

   • Flushing: Flush the cannula with saline to ensure patency and prevent clotting.

2. IV Site Maintenance:

   • Inspect every shift for signs of infiltration, phlebitis, or infection.

   • Replace the IV site every 72–96 hours or sooner if complications occur.

   • Document the date and time of insertion and any medications administered.

3. Infusion Monitoring:

   • Monitor infusion rates closely.

   • Watch for adverse reactions or IV complications (e.g., pain, swelling, redness).

   • Ensure that the infusion solution is compatible with the cannula size and patient's condition.

4. Removal and Disposal:

   • Remove the cannula using aseptic technique once therapy is complete.

   • Apply pressure to prevent bleeding and dress the site with sterile gauze.

Other Characteristics:

• Complications:

  • Phlebitis (vein inflammation)

  • Infiltration (fluid leakage into surrounding tissue)

  • Infection (local or systemic)

  • Thrombosis or occlusion

• Advantages:

  • Easy to insert and widely applicable.

  • Allows rapid administration of fluids and drugs.

  • Minimal invasiveness compared to central lines.

• Limitations:

  • Not suitable for highly concentrated or irritant medications.

  • Short-term use only (usually <4 days).

  • Limited flow rate compared to central access.

Conclusion:
Peripheral IV access is a fundamental component of modern medical care, providing a fast and effective route for administering fluids, medications, and blood products. In Dubai, it is utilized extensively across hospitals, clinics, and emergency departments following strict DHA protocols to ensure patient safety and procedural efficiency. While relatively simple, its proper insertion, maintenance, and monitoring are crucial to avoiding complications and ensuring successful therapy.