Understanding Vascular Access: A Patient’s Guide

What Is Vascular Access?

“Vascular access” is a medical term for safely reaching a vein (or, less commonly, an artery or bone) so that your healthcare team can give you medicine, fluids, or nutrition directly into your bloodstream, or take blood samples without repeated needle sticks.

The device used to do this — whether it is a small plastic tube in your arm or a more complex catheter — is called a vascular access device, or VAD. You may also hear it called an IV line, a catheter, a PICC, a port, or a central line. Each name refers to a slightly different device, but they all serve the same basic purpose: giving your care team a reliable, safe pathway into your bloodstream.

Why Do I Need Vascular Access?

Your doctor or care team may recommend a vascular access device for one or more of the following reasons:

To give you medications. Many powerful medicines — including antibiotics, cancer-fighting drugs, pain medications, and drugs that affect your heart — must be given directly into the bloodstream to work correctly. Some medicines would be harmful to your stomach or body tissues if swallowed or injected into muscle; a vein provides the safest and most effective route.

To give you IV fluids. If you are dehydrated, have had surgery, or cannot eat or drink, IV fluids (saline, dextrose, or electrolyte solutions) can restore your body’s fluid and salt balance quickly and reliably.

To give you nutrition. When you cannot eat normally for an extended period, a special IV nutrition formula called total parenteral nutrition (TPN) can provide calories, protein, fats, vitamins, and minerals through a vein.

To give you blood or blood products. Blood transfusions and products such as platelets or plasma are given through a vein.

To draw blood for lab tests. Rather than a new needle stick every time blood is needed, a vascular access device can be used to collect samples easily and with less discomfort — particularly when many tests are needed over days or weeks.

To monitor your blood pressure or heart function. In intensive care settings, certain catheters placed in specific arteries or large veins allow continuous, real-time monitoring of blood pressure and other vital measurements.

Who Places My IV or Catheter?

The person who places your device depends on the type of catheter:

Peripheral IVs (small IVs in your arm or hand) are usually placed by a registered nurse (RN) or a licensed practical nurse (LPN).
PICC lines and midline catheters are placed by specially trained nurses called PICC nurses or vascular access nurses, often with the help of ultrasound guidance.
Central venous catheters are typically placed by a physician, an advanced practice provider (nurse practitioner or physician assistant), or an interventional radiologist.
Implanted ports are surgically placed by a surgeon or interventional radiologist.

Vascular access is a specialty area of nursing and medicine. Many hospitals have dedicated vascular access teams — nurses and clinicians whose entire focus is on safely placing and caring for these devices.

What Happens During Placement?

The steps vary by device type, but in general:

Your team will explain the procedure. Before anything is placed, your nurse or doctor will tell you what they are planning to do, why, and what you should expect. You will have the opportunity to ask questions. For some procedures, you will be asked to sign a consent form. (See our guide: Your Rights: Informed Consent and Decision-Making.)
The area will be cleaned. The skin over your vein will be thoroughly cleaned with an antiseptic solution (usually chlorhexidine or iodine-based) to reduce the risk of infection.
You may receive local anesthetic. For anything more than a routine peripheral IV, a small amount of numbing medicine (local anesthetic) is injected under the skin so that you feel little or no pain during the procedure.
The device is placed. Using a needle, and often with ultrasound guidance so the clinician can see your vein in real time, the catheter is threaded into place. For central lines and PICC lines, the tip of the catheter sits in a large vein near your heart.
Placement is confirmed. For catheters whose tips sit near the heart, an X-ray or a special technology called ECG-tip confirmation is used to verify that the tip is in exactly the right position before the line is used.
The site is dressed and secured. A sterile dressing (transparent film and/or gauze) is applied over the insertion site, and the catheter is secured so it does not slip or come out accidentally.

How Long Will I Have the Device?

This depends entirely on what you need it for:

Device Type	Typical Duration
Peripheral IV (PIV)	3–4 days (often changed more frequently)
Midline catheter	Up to 4 weeks
PICC line	Weeks to months
Non-tunneled central venous catheter	Days to a few weeks
Tunneled central catheter (e.g., Hickman)	Months to years
Implanted port	Years

Your team will remove the device as soon as it is no longer needed for your care. Devices that are no longer being used are removed promptly because every day a catheter remains in place carries a small risk of infection or complication.

Will It Hurt?

Placement: There is usually a brief sting when the local anesthetic is injected (if used) or when the initial needle enters the skin. After that, most patients report feeling pressure or movement but not significant pain.

During use: You should not feel pain from a properly functioning vascular access device. A dull ache or pressure can be normal, but sharp pain, burning during infusion, or significant discomfort at or around the insertion site should always be reported to your nurse immediately.

Removal: Removal of most catheters is quick and causes minimal discomfort — usually just a brief pulling or pressure sensation.

What Is My Role in Keeping the Device Safe?

You are an important part of your own safety. While your care team manages the technical aspects of vascular access, there are things you can do:

Tell your nurse right away if the site looks red, swollen, or feels painful, or if the dressing is loose or wet.
Do not touch, pull on, or adjust the catheter or dressing yourself.
Wash your hands before and after touching anything near the catheter site.
Tell your team about allergies — especially to tape, adhesives, latex, or any medications.
Ask questions any time you are unsure about what is happening with your device.

For detailed information, see the related guides in this series, including Keeping Your IV Safe: Infection Prevention and Recognizing Complications: When to Call for Help.

This guide is for educational purposes and is not a substitute for advice from your own healthcare team. Always follow the specific instructions given to you by your nurses and doctors.