IV Site Replacement Guidelines
Peripheral intravenous catheters in adults should be replaced every 72-96 hours to prevent phlebitis and other complications. 1
Specific Replacement Timeframes by Catheter Type
Peripheral Venous Catheters
- Adults: Replace every 72-96 hours
- Children: Leave in place until IV therapy is completed unless complications occur
- Emergency insertions: Replace within 48 hours when aseptic technique cannot be ensured
Central Venous Catheters
- Do not routinely replace central venous or arterial catheters solely to reduce infection risk
- Replace based on clinical indication rather than arbitrary time intervals
Administration Set Replacement Guidelines
| Type of Administration Set | Replacement Frequency |
|---|---|
| Standard IV tubing (crystalloids) | Every 72 hours |
| Blood/blood products tubing | Within 24 hours of starting infusion |
| Lipid emulsions tubing | Within 24 hours of hanging solution |
| Propofol infusion tubing | Every 6-12 hours (per manufacturer) |
Monitoring and Maintenance
Signs requiring immediate catheter removal:
- Phlebitis (redness, pain, swelling at insertion site)
- Infiltration (fluid leaking into surrounding tissue)
- Occlusion (blockage)
- Signs of infection
- Catheter no longer needed for therapy
Dressing changes:
- Replace when the catheter is removed/replaced
- Replace when dressing becomes damp, loosened, or soiled
- For central lines: Replace gauze dressings every 2 days and transparent dressings every 7 days
Special Considerations
- Needleless components: Change at least as frequently as the administration set
- Injection ports: Clean with 70% alcohol or iodophor before accessing
- Parenteral fluids: Complete lipid-containing solutions within 24 hours, blood products within 4 hours
Evidence-Based Insights
Recent research suggests that clinically-indicated replacement (rather than routine timed replacement) of peripheral IV catheters may be appropriate in some settings 2. However, the CDC guidelines still recommend the 72-96 hour replacement interval for adults to prevent complications 1.
The evidence shows that routine replacement reduces the risk of infiltration and catheter blockage compared to clinically-indicated replacement 2, though there is no clear difference in rates of catheter-related bloodstream infections between the two approaches.
Common Pitfalls to Avoid
- Failing to inspect IV sites at each shift change
- Submerging catheters in water (showers permitted with impermeable protection)
- Replacing central lines on a fixed schedule rather than based on clinical indication
- Using organic solvents (acetone, ether) on the skin during insertion or dressing changes
Remember that proper insertion technique and ongoing site assessment are as important as timing of replacement in preventing IV-related complications.