IV size, Go Big or Go Home

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This topic contains 13 replies, has 5 voices, and was last updated by Profile photo of RustBeltRN RustBeltRN 8 months, 1 week ago.

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  • #49685

    If you have to start an IV on a patient, do you use the biggest needle the vein will tolerate, the smallest needle required for the known meds, or somewhere in between.

    If I can get an 18g needle in, I do that, but will go down in size to a 20 if needed. On adults I will usually use the ultrasound to get an 18 or 20g in before going any smaller than that, while kids I will use a 22 on toddlers and 24 on babies.

    If they are actively dying and I can get it, they will get a 16 or 14g needle, but otherwise I save these for people that spit. If their vitals have me worried or they need several meds, they get at least two IVs.

    What rules do you follow (or personal guidelines) when it comes to IV number and size?

    Profile photo of Jeannine Smith

    As a med-surg nurse, I never really was as comfortable with IV’s as I wished to be. Now that I’m a dialysis nurse, 17g needles are our “small” needles. We go up to 14g on some patients and our standard is a 15g.


    I work in ICU, always try to have 18s if no central line. For vasopressors or other irritating meds, if it has to go via a piv, then I do a 22g, the smaller gauge allows more blood to flow around it, and decreases irritation at the site.

    Profile photo of mismonique

    My favorite is 22g

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