Peripheral Access Quick Guide

Tips and tricks for securing peripheral access

Prepare, prepare, prepare

Contact the donor and remind them to...

• Drink an extra 12 cups of water per day
• Limit caffeine
• Avoid alcohol 

...while taking filgrastim

Be prepared for complications and know your plan if a central line is needed

On day of collection

• Warm body – hands & arms most important at least 5 minutes prior to securing access
• Heat up 250ml saline bags and have donor hold one bag in each hand
• Use tourniquet to identify vein with good diameter & depth
• Go after what you feel, not what you see
• Rotate palm/wrist to evaluate different vein position
• Always anchor vein when sticking with non-dominate thumb (pull away from antecubital area and press down)

---

Return line

• Use 18 gauge peripheral IV over metal needle
• Placement – start distal and work up arm if needed
• 1st choice – hand, 2nd choice – wrist, 3rd – antecubital
• With tourniquet on, tap and rub area where veins are located to increase dilation

Access line

• Use fixed metal backeye 16-18 gauge needle
• Use tourniquet and/or blood pressure cuff to add pressure
• Use pillows under arm to give support
• Try to use median cubital and cephalic vein
• After access obtained, loosen tourniquet and leave on for first 30 minutes
• Keep arm straight, outstretched, and cover with blanket

Troubleshooting

• If no blood return or unable to flush the lines, cannulation of the vein has not occurred. Restart.
• Monitor for signs of infiltration
• If vein cannot accommodate entire cannula, you can secure the partially inserted catheter with tape
• Do not force the catheter in
• If catheter can only partially advance and meets resistance, connect to IV fluids and advance catheter with fluids helping you pass into the vein
• Use blood pressure cuff instead of tourniquet
• Double tourniquet, first Velcro and then non-latex over the Velcro
• Dangle arm off side of chair

Still having trouble?

Contact Transplant Medical Services at TMS@nmdp.org or contact via phone at 888-510-1808 or 763-406-4400