Before your IV class

Ask about prior access and preferences, assess vessels and use a validated DIVA tool adopted by the facility. Arrange appropriate trained support or visualization early. The AVA paper recommends no more than two attempts per clinician within a defined escalation pathway, rather than repeated attempts by successive clinicians. Known difficulty is a reason to escalate earlier.

No. Confirm formulation, concentration, rate, peripheral compatibility, vessel condition, patient risks and follow-up with pharmacy and the clinical team. A midline remains peripheral. Duration and chemical values are inputs, not independent guarantees. In the MacRx class, use the policy requirements in the assigned track and ask the educator to address a conflict.

Stop the infusion and assess promptly. Suspected extravasation requires the agent-specific protocol; do not flush. Preserve access if required for aspiration or antidote before removal. Escalate to the treating team/pharmacy and document findings, timing, actions, communication and the plan. Do not apply an automatic removal rule to every device and complication.