PEM Playbook – Pediatric IV Tips and Tricks

Originally published at Pediatric Emergency Playbook on February 1, 2021 – Visit to listen to accompanying podcast. Reposted with permission.

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Top 10

Set the stage – exude confidence and be prepared
Choose the right cannula size – a smaller working IV is infinitely better than none
Feeling is better than looking – trust yourself
Mark the site – things get wonky when you take your hands off to disinfect
Tourniquets can mess you up – try to use a holder’s hand to occlude the vein
The holder rules – get as many hands on deck as you need.
Tension is good – a little counter traction on the skin with your non-dominant hand helps to decrease the friction as the needle goes through the fascial layers.
Stay in line – your needle is an extension of your arm
Gravity is your friend – the kinder, gentler tourniquet
The 3 Fs – flash, flatten, and forward. Get the flash at a 30 degree angle, flatten that angle, (advance another 1mm), and advance the plastic catheter over the needle into success

Fantastic tutorial by Brienne Leary, Medical-Surgical ICU nurse from Boston Children’s Hospital

Excellent start-to-finish demonstration and example by Dr Aman Kalra, Pediatric Anesthesiologist at Tufts Medical Center

The one-and-only Dr Larry Mellick interviews seasoned pediatric emergency RN