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How to Choose The Right IV Needle

by Lisa Zelaya on Feb 14, 2020
How to Choose The Right IV Needle

When choosing the size of an IV needle, it's important to consider your patient. Smaller gauge needles are larger and stick out more when in a vein.

When selecting the proper gauge of an peripheral IV catheter, making sure it meets the patient's needs is key. This means considering many factors including prescribed therapy/type of solution, duration of treatment, vein availability and integrity with age in mind as well known complications when choosing a device.

The Infusion Nurses Society standards of practice states that the smallest gauge and length with the fewest number of lumens should be used. It is important to use a device that will accommodate your prescribed therapy without complications or difficulties.

Different Types of IV Gauge Needles: 18, 20, and 22 Gauge Needles

One of the most important things to know when starting an IV is how big your needle needs to be. Needles are sized by gauges, and smaller numbers indicate thicker needles . There are three common sizes: 18-gauge, 20-gauge and 22-Gauge. In this article we'll discuss each one in detail.

When you are in the hospital, all of your IV needles will be color coded with different colors. The number 22 needle is blue and 18 is green. Pink stands for a medium gauge size that fits right in between them both!

As a new nurse, it may seem difficult to spot different sized gauges during an emergency situation where speed matters most - but luckily many manufacturers color code their IV needles so you can easily identify which one works best under pressure when time isn't on your side! To help remember what each colored marker means, here's a little rhyme: "22" equals 'blue' while "18" equates to 'green'. You guessed it- pink represents the middle ground known as Medium Gauge!"

In addition to the aforementioned common sizes, there are also two less-used IV gauge types: 24 and 16. The former is often used for pediatrics due its smaller size while the latter can be found in Intensive Care Units or during surgery procedures.

However, you'll most frequently work with 18-, 20-, and 22-gauge needles as a nurse - they're frequent across various areas of nursing .

The Importance of Selecting the Right Gauge

Needles come in all different sizes and gauges. For example, big needles are used for blood draws while small ones can be used to give injections or take out stitches from procedures such as skin biopsies that need smaller instruments than a scalpel could offer. The reason it’s important to use the right gauge is because some nursing procedures only require certain sized needle(s). If you have a patient who needs their blood drawn, you should go with large enough one so there isn't any re-sticks which may cause them frustration and pain.

So, before you start an IV on a patient, ask yourself what type of procedures your patient will have while in care. Common uses for the different gauge sizes are listed below. Note that each institution has its own set protocols so always check with them first!

  • 16 Gauge: This size of IV is mostly used in the ICU or surgery areas. The large size enables many different procedures to be performed, such as blood administration and rapid fluid administration among others
  • 18 Gauge: This large sized catheter is best for pushing fluids rapidly or administering blood. You can use this size to complete CT PE Protocols and other testing that require a larger IV tube.
  • 20 Gauge: With a smaller gauge, you may be able to push blood through this size if you can't use an 18-gauge. However, always check your employer's protocol as it is probably better for patients with smaller veins.
  • 22 Gauge: This small size is perfect for when patients won't need an IV long or are not critically ill. As it's usually too small to administer blood, some hospital protocols allow 22 G usage if necessary.
  • 24 Gauge: This size is usually only used as a last resort for an IV in the adult population. It should be your first choice if you're working with pediatrics.

*Always check with your hospital's protocol about blood product administration. You may be able to use 20 or 22 gauge IV needles, but some hospitals require a central line and will only allow you to administer through those lines using smaller gauges (18g-20g).

Technology of IVs in Nursing Today

Although the needle retracting feature is a modern and welcome addition to IV designs, it was not always widely available. In fact, in prior years when nurses would place an intravenous line (IV), they typically used needles that stayed inside of the patient’s arm for their full shift or until blood work came back negative. Nowadays though these types of procedures require significantly less time to complete since once you insert your cannula into the vein with little resistance; its sharp tip will automatically withdraw itself from sight without any additional effort on your part!

The retractable needle safety feature found on most IVs today can dramatically decrease the risk of accidental needle sticks. Many nurses have been infected with serious or even fatal diseases from needles, so this is a very important issue to address in healthcare settings. 

When you choose the right needle size and you are still not confident about venipuncture, you can choose additional venipuncture equipment to help you find the most right vein, reduce the number of punctures, improve the success rate and patient satisfaction.

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