Author: Matt Vera BSN RN
Starting an IV to a pediatric patient is extra challenging as their veins are smaller and are sometimes distressed when they see a needle. Hopefully, these IV tips for pediatric patients can help you:
Keep calm and calm the child. When starting an IV on an infant, try soothing them beforehand with a pacifier. If mom wants to hold the baby, as if bottle/breastfeeding is okay while starting the line.
Insert on nondominant hand. Hand veins in the nondominant hand are preferable for small children of walking age and infants.
Use an immobilizer. The antecubital (AC) is also a good location for children, but an immobilizer board may be required to keep the line patent.
Scalp veins. In neonates, scalp veins or veins in the feet are sometimes preferable and easier to access, especially in the cute chubby babies!
Advance on flashback. With preemies and small newborns, try advancing the catheter instead of the needle after the initial flashback of blood. Babies veins aren’t mature yet, and you may blow a vein by advancing the needle.
It’s a TB skin test. One nurse told me, “think of it like a TB skin test.” Stick almost flush with the skin when sticking neonates and newborns. Many times, their veins are close to the skin’s surface.
Less pain. Use anesthetic creams or sprays for children.
Know your nursery rhymes. When starting an IV on a toddler (ages 1-3), try singing, pacifiers or musical toys as a means of distraction. Hint: Itsy Bitsy Spider works wonders for my son and other kids, too, especially when accompanied with hand motions! Give it a shot.
Communicate. With young children ages 4 and up, just be honest with them. Kids can comprehend more than you may think and, therefore, can see reason. Tell them that the procedure will hurt, but only for a minute. Assure them that they will not lose all of their blood. It also wouldn’t hurt to “bribe” the kid to hold still with stickers, toys, etc.
Avoid tourniquets if you can. Apply traction with your hands and utilize coworkers when available. The use of tourniquets increases your risk of blowing veins on children.
Dangle that arm. Having the patient dangle their arm off of the side of the bed or let it hang by their side prior to sticking will increasing blood flow to that extremity. Veins will be easier to feel and see.
Know when to stop. It’s not good patient care to repeatedly stick them 4 or 5 times blindly. Find someone else with more experience to try. Everyone had bad days.