Chart — IV Therapy

Vascular Access Device Comparison

Peripheral IV, midline catheter, PICC, CVC, and implanted port compared by insertion site, tip location, dwell time, advantages, limitations, and typical clinical use.

Educational use only. This material supports nursing education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional policy, or medical direction. Always follow facility protocols and current provider orders.

Summary Comparison

Device	Tip Location	Duration	Central?	TPN / Vesicants	Inserted By
Peripheral IV	Peripheral vein	72–96 hrs	No	No	Any trained RN
Midline	Axillary vein	1–4 weeks	No	No	Trained RN / vascular team
PICC	SVC (CXR req'd)	Weeks–months	Yes	Yes	PICC-certified RN / IR
CVC	SVC or IVC (CXR req'd)	Days–weeks	Yes	Yes	Physician / APRN
Port	SVC	Years	Yes	Yes	Surgeon / IR (implant)

Device Details

Peripheral IV (PIV)

14–24 G

Insertion Site: Forearm, dorsal hand, antecubital (last resort)

Tip Location: Peripheral vein

Duration: 72–96 hours

Typical Use: Short-term fluids, medications, blood transfusion (≥18 G)

Advantages

Bedside insertion by RN
Lowest cost
No imaging required
Easiest to replace

Limitations

Short dwell time
No TPN or vesicants
High per-day complication rate
Painful with irritating medications

Midline Catheter

3–5 Fr

Insertion Site: Upper arm (basilic, cephalic, or brachial vein)

Tip Location: Axillary vein (NOT SVC — not a central line)

Duration: 1–4 weeks

Typical Use: IV antibiotics 1–4 weeks, hydration, poor peripheral access

Advantages

Longer dwell than PIV
No daily changes
Better patient comfort
Bedside insertion

Limitations

NOT central — no TPN or vesicants
Osmolarity limit <600 mOsm/L
Thrombosis risk
Requires trained inserter

PICC

3–6 Fr, 1–3 lumensCentral Line

Insertion Site: Upper arm (basilic preferred) → threaded to SVC

Tip Location: Superior vena cava (CXR required before use)

Duration: Weeks to months

Typical Use: Long-term antibiotics, TPN, chemotherapy, repeated blood draws

Advantages

Full central capabilities
Bedside insertion by PICC RN
Lower CLABSI risk than CVC if maintained
Power-injectable models available

Limitations

CXR required before first use
No BP on insertion arm
Thrombosis risk (upper extremity DVT)
Requires PICC-certified inserter

Central Venous Catheter (CVC)

Multi-lumen (1–4), large boreCentral Line

Insertion Site: Internal jugular (IJ), subclavian, or femoral → SVC or IVC

Tip Location: Superior vena cava (IJ/SC) or IVC (femoral); CXR required

Duration: Days to weeks

Typical Use: ICU patients, vasopressors, TPN, resuscitation, hemodynamic monitoring

Advantages

Multiple incompatible infusions simultaneously
Rapid volume infusion
CVP monitoring
Immediate bedside insertion (ICU)

Limitations

Highest CLABSI risk
Femoral site: ↑↑ infection + DVT
Physician/APRN to insert
Pneumothorax risk (subclavian)

Implanted Port (Port-a-Cath)

Accessed with non-coring Huber needle onlyCentral Line

Insertion Site: Chest wall (surgically implanted); catheter → SVC

Tip Location: Superior vena cava

Duration: Years (accessed intermittently)

Typical Use: Chemotherapy, monthly IVIG, long-term intermittent IV therapy over months to years

Advantages

Lowest CLABSI risk per day (fully implanted)
No external hardware between accesses
Patient can shower/swim freely
Ideal for long-term intermittent therapy

Limitations

Surgical implant required
Must use Huber needle (coring damages septum)
Not for rapid resuscitation
Difficult/surgical procedure to remove if infected

Key Nursing Rules

Topic	Rule
TPN & vesicants	Central access required (PICC, CVC, or port) — peripheral IV and midline are NOT appropriate
Blood transfusion compatible flush	Only 0.9% NS — never LR (calcium → clotting) or D5W
Midline vs PICC	Both inserted in upper arm — key difference: midline tip does NOT reach SVC; PICC does
Port needle	Must use non-coring Huber needle — regular needles permanently damage the silicone septum
CXR before use	Required for PICC and CVC — confirm SVC tip position before any infusion
Femoral CVC	Highest infection and DVT risk of all sites — use only when upper sites are unavailable
CLABSI bundle	Hand hygiene + max sterile barrier + CHG skin prep + optimal site + daily review of necessity
Scrub the hub	Clean needleless connectors for ≥15 seconds with CHG or 70% alcohol before every access

Related Resources

Vascular Access Devices ReferenceFull detail: indications, flushing, dressing, contraindications, and nursing care for each device

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Peripheral IV Insertion BasicsSite selection, gauge, insertion steps, securement

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IV Therapy ComplicationsCLABSI, infiltration, phlebitis, occlusion, air embolism

Open →

IV Infiltration vs ExtravasationWhy vesicants require central access — assessment, interventions, antidotes

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Data source: INS Standards of Practice for Infusion Nursing / CDC CLABSI Prevention Guidelines

Standards & sources

Fact-checked Jun 21, 2026

This page is written to align with INS Standards of Practice for Infusion Nursing / CDC CLABSI Prevention Guidelines. It is an educational summary, not a citation of any single document — always verify specific doses, values, and protocols against current guidelines and your facility policy. How we source content →