In this post, I link to and review the February 2019 podcast and show notes of EM Quick Hits 2 with reference to the section on Pediatric IV Cannulation. And reviewing the podcast and show notes, I reviewed some additional material listed in Resources below.
Here are the show notes from this portion of the podcast (26:07 – 33:30) Note to myself – but you need to listen to this portion of the podcast again also]:
What follows are the show notes from the above portion of EM Quick Hits 2:
Pediatric IV Cannulation Tips and Tricks
- Decide on the necessity and urgency – ask yourself if the IV needs to be placed now or can you delay while the child drinks or sucks on a popsicle and settles down
- Optimize in advance – consider topical analgesic such as EMLA, get all your equipment in advance, assess all limbs before committing to one location, gather the staff you’ll need
- Have a good look with your eyes +/- POCUS – the vein running across the proximal half of the 4th metacarpal joining with the vein running between the 4th and 5th metacarpal is likely to have a higher success rate than antecubital in the pediatric population; consider also the great saphenous vein at the ankle and the palmar aspect of the wrist
- Go low, go slow – use an angle that is almost flat along the skin and advance slowly
- Secure the IV as if your life depends on it with steristrips, tegaderm, 1 or 2 limb immobilization boards and bandaging
Resources
(1) IV Insertion Technique in Infants and Small Children YouTube Video. An outstanding teaching video.
(2) Newborn Care Series: Inserting an IV YouTube video. Also worth reviewing.
(3) Educational intervention to improve intravenous cannulation skills in paediatric nurses using low-fidelity simulation: Indian experience [PubMed Abstract] [Full Text HTML] [Full Text PDF]. BMJ Paediatr Open. 2017; 1(1): e000148.
(4) Peripheral intravenous (IV) catheter insertion for neonates [Link is to the web page]. From Better Safer Care Victoria, Page last updated: 23 Nov 2018.
(5) Royal Children’s Hospital Melbourne on peripheral IV access from EM Quick Hits 2 above.
