Hello All,

An oncology nurse has asked if a smaller gauge needle could be used when transfusing patients where IV access is a major concern. Our current policy requires a 20 gauge needle or larger.  She thinks using a smaller needle could possibly reduce the number of needle sticks difficult patients must endure and even possibly prevent the need for central line insertion.  She sent me a 2016 article from Infusion Nurses Society that states when using a short peripheral catheter, use 20 to 24 gauge based on vein size and patient preference.

I reviewed the Technical Manual.  It says acceptable intravenous catheter sizes for use in transfusing cellular blood components range from 22 to 14 gauge.  A 20 to 18 gauge intravenous catheter is suitable for the general adult population and provides adequate flow rates without excessive discomfort to the patient.  For infants and toddlers, a 24 to 22 gauge  may be suitable but requires infusion through a syringe.

The only post I found on this site is approximately four years old.  I am wondering what your policies are now.  Does anyone allow smaller than 20 gauge?

 

Thanks very much,

Cathy

Our nursing procedure says 20 g or larger.  Not sure where this comes from, probably Lippencott.

Scott

Our nursing procedure states:

Acceptable catheter size ranges from 14 to 25 gauge (6.3-1.5 French); use the largest size possible for the patient.

• 18-20 gauge (3.8-2.7 French) catheter provides adequate flow rates without excessive discomfort for the adult or larger pediatric patient.
• Catheters smaller than 20 gauge (2.7 French) will require slower flow rates to prevent hemolysis of red cells.
• Larger bore catheters (14-16 gauge/6.3-5 French) should be used for patients requiring rapid infusions.