Peripheral Access Quick Guide

Tips and Tricks for Securing Peripheral Access

Prepare, prepare, prepare

Contact the donor and remind them to…

  • Drink an extra 12 cups of water per day
  • Limit caffeine
  • Avoid alcohol

…while taking filgrastim

Be prepared for complications and know your plan if a central line is needed

On Day of Collection

  • Warm body – hands & arms most important at least 5 minutes prior to securing access
  • Heat up 250ml saline bags and have donor hold one bag in each hand
  • Use tourniquet to identify vein with good diameter & depth
  • Go after what you feel, not what you see
  • Rotate palm/wrist to evaluate different vein position
  • Always anchor vein when sticking with non-dominate thumb (pull away from antecubital area and press down)

Return Line

  • Use 18 gauge peripheral IV over metal needle
  • Placement – start distal and work up arm if needed
  • 1st choice – hand, 2nd choice – wrist, 3rd – antecubital
  • With tourniquet on, tap and rub area where veins are located to increase dilation

Access Line

  • Use fixed metal backeye 16-18 gauge needle
  • Use tourniquet and/or blood pressure cuff to add pressure
  • Use pillows under arm to give support
  • Try to use median cubital and cephalic vein
  • After access obtained, loosen tourniquet and leave on for first 30 minutes
  • Keep arm straight, outstretched, and cover with blanket


  • If no blood return or unable to flush the lines, cannulation of the vein has not occurred. Restart.
  • Monitor for signs of infiltration
  • If vein cannot accommodate entire cannula, you can secure the partially inserted catheter with tape
  • Do not force the catheter in
  • If catheter can only partially advance and meets resistance, connect to IV fluids and advance catheter with fluids helping you pass into the vein
  • Use blood pressure cuffinstead of tourniquet
  • Double tourniquet, first Velcro and then non-latex over the Velcro
  • Dangle arm off side of chair

Still having trouble?

Contact Transplant Medical Services at or contact via phone at 888-510-1808 or 763-406-4400


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