Pediatric IV Variations

Question 1

Where are a child’s veins located in comparison to adult’s veins?

Answer 1

Both are located in the same areas

Question 2

Why is it more difficult to find a child’s veins?

Answer 2

subcutaneous fat on children

Question 3

Where should you look first to choose an IV site for a pediatric patient?

Answer 3

EVERYWHERE

Question 4

When is it okay to place an IV in a pediatric patient’s foot?

Answer 4

if the child has not begun walking or won’t be walking during hospitalization

Question 5

What can be used to help locate veins in a child?

Answer 5

transilluminators

Question 6

Where is the most preferable area to place IVs in children?

Answer 6

a larger vein

Question 7

What can be used to promote vasodilation for infants?

Answer 7

heel warmers

Question 8

For older children, what can be used to promote vasodilation?

Answer 8

warm blankets or heel warmers taped to the area

Question 9

How long should we wait to attempt IV insertion after application of heat to promote vasodilation?

Answer 9

5-7 minutes

Question 10

Who is the most important person in the room aside from the child during an IV attempt?

Answer 10

the holder of the child

Question 11

How should a pediatric patient be held when getting an IV inserted?

Answer 11

firmly, but do not extend a joint beyond its normal limits

Question 12

Why is it important to not extend a joint beyond its normal limits for a pediatric patient being held?

Answer 12

it can cause joint damage to delicate joints

Question 13

What IV supplies are necessary for a pediatric IV start?

Answer 13

tourniquet, IV catheters and extension set, normal saline flushes, alcohol swabs, flush syringes, pediatric tegaderm/tape, mesh wrap

Question 14

What sizes do arm boards come in?

Answer 14

all sizes!

Question 15

What is important to remember to do if a pediatric patient has an arm board on?

Answer 15

assess the skin underneath frequently

Question 16

What is important to explain to parents when starting a scalp IV on a baby?

Answer 16

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

Question 17

Does a scalp IV hurt more than a peripheral IV for a child?

Answer 17

no

Question 18

What gauge needle should be used on a scalp IV for an infant?

Answer 18

smallest gauge feasible (either 22 or 24 gauge)

Question 19

When can a scalp be used for an IV?

Answer 19

if an infant is less than 9 months old

Question 20

The more hemodilution, the ______ the pediatric vein will last

Answer 20

longer

Question 21

How do you know if a tourniquet is too tight on a baby’s scalp?

Answer 21

the skin begins to turn purpleish red

Question 22

How should an infant’s hair be cut prior to a scalp IV insertion?

Answer 22

with scissors.. NEVER use a razor

Question 23

Why should a razor blade not be used when cutting a baby’s hair in preparation for a scalp IV?

Answer 23

it may cause micro-abrasions which can lead to infection

Question 24

Why are scalp veins great for babies 9 months of age and younger?

Answer 24

they have no valves, are easy to see, and they do not roll

Question 25

What angle should a scalp IV be placed and what direction should it be pointed?

Answer 25

30 degree angle with the tip of the cathlon pointed down towards the heart

Question 26

How should a catheter be advanced when placing a pediatric IV?

Answer 26

SLOWLY

Question 27

What are the three choices that parents have when you are starting an IV on the child?

Answer 27

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

Question 28

When should you inform the parent of their options and what will happen during an IV start?

Answer 28

before the procedure

Question 29

What does what and how you educate a child dependent on?

Answer 29

chronological age AND developmental age

Question 30

What should be done for a baby 1 year or younger when performing a procedure?

Answer 30

focus on educating the parents, provide comfort measures, and encourage the baby to hold his or her favorite blanket or toy

Question 31

How should you explain an IV start to a toddler (age 1-3)?

Answer 31

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

Question 32

What is the preschool age also known?

Answer 32

the show and tell age

Question 33

What is a technique that will help in starting an IV in a preschool child?

Answer 33

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

Question 34

What should you encourage in a preschool aged child when starting an IV?

Answer 34

the child should hold his or her blanket or favorite toy

Question 35

When should you be making sure to praise children for their cooperation (at what age)?

Answer 35

during the preschool years