Pediatric IV Variations Flashcards
Where are a child’s veins located in comparison to adult’s veins?
Both are located in the same areas
Why is it more difficult to find a child’s veins?
subcutaneous fat on children
Where should you look first to choose an IV site for a pediatric patient?
EVERYWHERE
When is it okay to place an IV in a pediatric patient’s foot?
if the child has not begun walking or won’t be walking during hospitalization
What can be used to help locate veins in a child?
transilluminators
Where is the most preferable area to place IVs in children?
a larger vein
What can be used to promote vasodilation for infants?
heel warmers
For older children, what can be used to promote vasodilation?
warm blankets or heel warmers taped to the area
How long should we wait to attempt IV insertion after application of heat to promote vasodilation?
5-7 minutes
Who is the most important person in the room aside from the child during an IV attempt?
the holder of the child
How should a pediatric patient be held when getting an IV inserted?
firmly, but do not extend a joint beyond its normal limits
Why is it important to not extend a joint beyond its normal limits for a pediatric patient being held?
it can cause joint damage to delicate joints
What IV supplies are necessary for a pediatric IV start?
tourniquet, IV catheters and extension set, normal saline flushes, alcohol swabs, flush syringes, pediatric tegaderm/tape, mesh wrap
What sizes do arm boards come in?
all sizes!
What is important to remember to do if a pediatric patient has an arm board on?
assess the skin underneath frequently
What is important to explain to parents when starting a scalp IV on a baby?
the baby’s tiny veins and the fact that veins in the extremities are hidden by lots of baby fat, it is easier to see the veins and start an IV
Does a scalp IV hurt more than a peripheral IV for a child?
no
What gauge needle should be used on a scalp IV for an infant?
smallest gauge feasible (either 22 or 24 gauge)
When can a scalp be used for an IV?
if an infant is less than 9 months old
The more hemodilution, the ______ the pediatric vein will last
longer
How do you know if a tourniquet is too tight on a baby’s scalp?
the skin begins to turn purpleish red
How should an infant’s hair be cut prior to a scalp IV insertion?
with scissors.. NEVER use a razor
Why should a razor blade not be used when cutting a baby’s hair in preparation for a scalp IV?
it may cause micro-abrasions which can lead to infection
Why are scalp veins great for babies 9 months of age and younger?
they have no valves, are easy to see, and they do not roll
What angle should a scalp IV be placed and what direction should it be pointed?
30 degree angle with the tip of the cathlon pointed down towards the heart
How should a catheter be advanced when placing a pediatric IV?
SLOWLY
What are the three choices that parents have when you are starting an IV on the child?
Be an observer, who watches quietly
Sit near the head of their child and quietly talk to the child and possibly stroke the child’s hair
Step outside the room, perhaps grab coffee or a quick bite to eat
When should you inform the parent of their options and what will happen during an IV start?
before the procedure
What does what and how you educate a child dependent on?
chronological age AND developmental age
What should be done for a baby 1 year or younger when performing a procedure?
focus on educating the parents, provide comfort measures, and encourage the baby to hold his or her favorite blanket or toy
How should you explain an IV start to a toddler (age 1-3)?
Keep the explanation short and simple
Let the child know that it is okay to scream and cry, but they cannot kick, bite, or hit
Describe how the stick will feel
make sure the child understands that only one part of the body will be involved in the procedure
What is the preschool age also known?
the show and tell age
What is a technique that will help in starting an IV in a preschool child?
performing modified IV start on a stuffed animal or doll and allow child to touch and handle the tourniquet, alcohol pad/chloraprep, tape, and plastic IV cathlon
start the IV as soon as possible after the explanation
What should you encourage in a preschool aged child when starting an IV?
the child should hold his or her blanket or favorite toy
When should you be making sure to praise children for their cooperation (at what age)?
during the preschool years
