IV Line Change Protocol

Peripheral IV Catheter Replacement

The Centers for Disease Control and Prevention (CDC) recommends replacing peripheral venous catheters at least every 72-96 hours in adults to prevent phlebitis 1, 2, 3, 4
In children, leave peripheral venous catheters in place until IV therapy is completed, unless complications such as phlebitis or infiltration occur 1, 2, 3, 4
When aseptic technique cannot be ensured during catheter insertion, replace all catheters as soon as possible and no later than 48 hours after insertion 1, 2, 3, 4

Replace administration sets, including secondary sets and add-on devices, no more frequently than every 72 hours unless catheter-related infection is suspected 1, 2, 3, 4
Replace tubing used to administer blood, blood products, or lipid emulsions within 24 hours of initiating the infusion 1, 2, 3, 4
For solutions containing only dextrose and amino acids, administration sets do not need replacement more frequently than every 72 hours 1, 2
Replace tubing used to administer propofol infusions every 6 or 12 hours per manufacturer's recommendation 1, 2, 3, 4

Do not routinely replace central venous or arterial catheters solely for infection prevention purposes 1, 2, 3, 4
Central lines should remain in place until no longer clinically needed or until complications develop 1, 2, 3, 4

Change transparent dressings on central venous catheters every 7 days for short-term catheters 5
Change gauze dressings every 2 days on central venous catheters 5
Use gauze dressings preferentially if the catheter site is bleeding, oozing, or if the patient is diaphoretic 3, 4, 5
Change any dressing immediately when it becomes damp, loosened, or soiled 5

Clean injection ports with 70% alcohol or an iodophor before accessing the system 1
Wipe access ports with appropriate antiseptic and access only with sterile devices to minimize contamination risk 1, 2, 3, 4
Cap all stopcocks when not in use 1
Do not submerge catheters under water 2, 3, 4
Showering is permitted if the catheter and connecting device are protected with an impermeable cover 2, 3, 4

Avoid routine scheduled replacement of central lines, as this practice increases costs and patient discomfort without reducing infection rates 1, 2, 3, 4
Remember lipid-containing solutions require 24-hour tubing changes regardless of the 72-96 hour rule for crystalloids 1, 2, 3, 4
Emergency placements require early replacement, with catheters placed during emergencies without strict aseptic technique being replaced within 48 hours 1, 2, 3, 4

The Centers for Disease Control and Prevention recommends replacing peripheral venous catheters at least every 72-96 hours in adults to reduce phlebitis risk, though they may remain in place longer if venous access sites are limited and no signs of complications are present 6
In pediatric patients, peripheral catheters should be left in place until IV therapy is completed, removing only when complications develop 6
For chemotherapy administration, flexible cannulae should be used instead of steel "butterfly" needles for vesicant drugs 7
For vesicant drug infusions lasting 12-24 hours, central venous access is highly recommended over peripheral access 7
Adults should not have peripheral catheters placed in lower extremity sites; if placed there during emergency, replace to upper extremity as soon as possible 6
Cannulation over joints, inner wrist, anticubital fossa, or dorsum of hand, particularly for vesicant drugs, should be avoided 7

Midline catheters should not be routinely replaced based on duration alone and may remain in place indefinitely as long as they remain functional without signs of complications 6
The CDC explicitly recommends against routine replacement of midline catheters to reduce infection risk (Category IB recommendation) 6
Daily monitoring of the insertion site is required, including palpation through the dressing to detect tenderness and visual inspection if using transparent dressing 6

Central venous catheters should not be routinely replaced for infection prevention and may remain in place as long as clinically needed 6
Remove central venous catheters only when no longer clinically needed or when complications develop 6