Central and Peripheral Medication Administration Practices in Pediatric Patients

Required reading for all learners: Implicit Bias impacts patient outcomes

Several medication properties should be considered when deciding on central versus peripheral administration, including osmolarity, pH, and concentration. The cumulative risk of phlebitis and the caustic nature of some medications due to these properties will help guide the practitioner, pharmacist, and bedside nurse to determine the ideal prescribing, preparation, and administration techniques to avoid extravasation. Medications that are caustic, high volume or concentration, or a high osmolarity may require central venous catheter administration to avoid burning and to limit the likelihood of extravasation. The purpose of this article is to review complications of central venous catheters, to explain medication properties that should be evaluated when deciding on central or peripheral administration, and to evaluate the literature on peripheral administration of historically centrally administered medications..