What is the suggested maximum number of attempts to place a PIV before escalating to a vascular access team?

The suggested maximum number of attempts to place a peripheral intravenous (PIV) catheter before escalating to a vascular access team is generally recognized as four attempts. This guideline is based on best practices in vascular access, which aim to reduce patient discomfort and anxiety associated with multiple venipunctures, as well as to preserve vascular access sites for future needs.

After four attempts, the likelihood of successful placement diminishes, and the potential for complications such as bruising, infiltration, or phlebitis increases. Additionally, at this point, the expertise of a vascular access team, equipped with advanced skills and possibly ultrasound guidance, may provide a higher success rate and a better overall experience for the patient. This transition also supports a standard practice of ensuring patients are treated with the utmost care and efficiency, minimizing harm and enhancing treatment outcomes.

Understanding this protocol underscores the importance of developing a structured approach to vascular access, which balances the necessity of establishing intravenous access with the comfort and safety of the patient.