• Vascular access in nonemergent situations or
temporary access in emergent situations.
• Administration of fluids and electrolytes.
• Administration of intravenous medications.
• Administration of blood and blood products.
• Blood sampling.
• Do not insert through an infected site.
• Do not insert through a burn.
• Do not insert in an injured site.
• Avoid a paralyzed extremity.
• Do not insert in a massively edematous extremity.
• Do not insert an IV distal to injured organs (eg, do not use lower
extremities when treating abdominal injuries).
• Avoid joint area.
• Tourniquet or rubber band.
• Tape and occlusive transparent dressing.
• Alcohol wipes.
• Povidone or chlorhexidine.
• Syringe filled with injectable saline.
• Gauze pads.
• IV device: catheter or butterfly of appropriate size to fit the
patient and the task.
• Topical anesthetic cream.
• Plan the procedure.
• Limit the procedure time.
• Have a backup plan.
• Examine all possible sites carefully before choosing one.
• Apply gentle circumferential pressure with 1 hand on the extremity
to fill up the veins, which helps identify the most appropriate
• In choosing the equipment and the site for the line, consider
the patient’s needs.
• Introduce yourself to the parents and to the
• Explain to the parents and the child, if appropriate, the procedure
and its purpose.
• Choose 1 or more possible sites, and apply topical anesthetic
• Answer all of the parents’ and patient’s questions.
• Position the patient with the chosen site closest
• Have a helper gently restrain and distract the child.
• Have the patient at a comfortable working height.
• For external jugular line placement, have the patient’s head
lower than the trunk (Trendelenburg).
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