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What Are the Different Intravenous Injection Sites?

Susan Abe
Susan Abe

Intravenous injections are those administered directly into a peripheral or central vein of the circulatory system. Potential adult intravenous (IV) injection sites include those areas where veins lie close to the skin and are large enough to withstand the pressure and volume infusion of an intravenous injection. Usually visible and even palpable to a trained healthcare worker, these peripheral intravenous injection sites are primarily located in the upper extremities or arms. IV sites can be located in the legs, but IV injection sites in the lower extremities are difficult to reach and more painful to use. Central intravenous injection sites are often difficult to reach with a standard IV cannula or a hypodermic needle and usually require placement of an indwelling central catheter — such as a PICC line or subclavian line — before an IV medication can be administered.

As noted above, the most common intravenous injection sites are in the upper extremities and involve those of the back of the hands, the front and back of the lower arm and the antecubital fossa, or elbow. Veins in the legs are difficult to locate given the musculature of the lower extremities. Further, complications to IV administrations in the legs can result in more serious side effects, such as blood clots and venous insufficiency secondary to valve damage. Femoral veins are not recommended as a standard intravenous injection site due to the blood vessel's deep location and proximity to the femoral artery and femoral nerve. Veins in the feet are usually small and painful to utilize for IV injection sites.

An intravenous drip.
An intravenous drip.

The administration of an intravenous injection is an entirely different procedure than the administration of an intramuscular (IM) injection. These injections are administered deep into the body of a muscle, such as the deltoid or the gluteus. After the syringe is inserted, the plunger is pulled back to determine if a vein has been punctured before the medication is injected to ensure that the medication is administered intramuscularly and not intravenously. Intravenous administration causes a much faster drug action time than does intramuscular administration. While some medications can be administered both IV or IM, some are restricted to one route or dangerous side effects can occur.

A person with an intravenous line in her hand.
A person with an intravenous line in her hand.

Finally, potential intravenous injection sites depend upon whether the purpose of the injection is for a medicinal purpose or is related to recreational drug use or addiction. Individuals seeking intravenous injection sites for recreational drug use often use sites that would never be considered in a medical situation. Areas more often used for recreational IV injections might include the upper arm and the legs, for example.

Discussion Comments

anon926306

I noticed something very odd. During the Tim McVeigh execution, he was given the death cocktail through the leg, not through the arm. Many people in the health field questioned this. Can anyone shed some light on this practice?

ddljohn

@fify-- Peripheral veins are very difficult to locate in infants too. That's why injections to infants are usually given through the scalp.

SarahGen

@fify-- I think arms are the least painful injection sites. Hands are painful as you said. I once had to have an intravenous injection through my foot and that was painful too.

But intravenous injection is the fastest way to get a medication into the system. In emergencies when time is valuable, this is the only way. So pain is not an important factor in my opinion. I can deal with some pain for my well-being if I have to.

fify

Whenever I need an intravenous injection at the hospital, the nurses always look at the inside of my forearm first. They will tie something to my upper arm to try and see the vein. But my veins are very difficult to locate. They always tell me that the veins are deep under my skin and hard to feel with the fingers.

Some nurses are very good and can find them despite this. But a couple of times, I've had to have an intravenous injection through my hand. They use a winged infusion to go into my hand. I hate this because it's so painful. I barely feel a needle going into a vein in my arm but a needle going into a vein on my hand is horribly painful.

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    • An intravenous drip.
      By: Judex
      An intravenous drip.
    • A person with an intravenous line in her hand.
      By: pzAxe
      A person with an intravenous line in her hand.
    • An IV cannula for use with a peripheral IV line.
      By: Aleksandrs Jermakovi
      An IV cannula for use with a peripheral IV line.
    • Intravenous injection sites may include the antecubital fossa, or elbow.
      By: SENTELLO
      Intravenous injection sites may include the antecubital fossa, or elbow.
    • The upper arms are common for injections, both medical and recreational.
      By: skampixelle
      The upper arms are common for injections, both medical and recreational.