Peripheral Vascular Access Care and Management

Despite innovations in practice and peripheral vascular access device (PVAD) manufacture, PVADs use is associated with frequent complications amongst infants. Most complications are clinically minor, but some can be life-altering. All complications are a source of pain for infants and can cause increased stress and dissatisfaction for parents. The high incidence of vascular access related complication seen in neonatal intensive care units (NICUs) are partly due to the vulnerabilities of this patient group. However, some factors are potentially modifiable. Examples include the number of skin breaking procedures, infection prevention measures, technical skills around PVAD insertion, and infusion management. This chapter focuses on issues surrounding the ensuring of safe infusions, detecting, and managing vascular access related complications, such as phlebitis and the potentially serious condition of peripheral intravenous infiltration/extravasation (PIVIE).