IV Access in Babies: 4 TOP TIPS

Summary

This video offers four essential tips for successfully securing an IV line in infants, a notoriously difficult procedure. The first tip emphasizes using the right catheter size, recommending a 24-gauge for small babies. The second tip suggests selecting the best site, such as the foot or hand, for the IV. The third focuses on immobilizing the baby to prevent movement during insertion. Finally, the fourth tip highlights using the free hand to stabilize the vein and skin. Demonstrating these techniques, the video provides expert guidance on achieving effective IV insertion in a small infant, ensuring successful access while minimizing stress and difficulty.

Takeaways

• 😀 Peripheral IV access can be challenging in infants due to small veins, excess adipose tissue, and infant movement.
• 😀 A 24-gauge short catheter is recommended for IV placement in babies, as it offers an effective flow rate without the complications of larger gauges.
• 😀 Using a 24-gauge IV in a baby weighing 4-5 kg is equivalent to using two 18-gauge IVs in an adult running wide open.
• 😀 The best sites for pediatric IV placement are the feet, especially the saphenous or soft veins, as they are easier to secure than hand veins.
• 😀 Immobilizing the infant is crucial for successful IV access, as movement makes the process nearly impossible.
• 😀 Using the free hand to stabilize the vein and skin is essential for proper IV placement without collapsing the vein.
• 😀 Transillumination can be used to identify veins, particularly in the hand area for more accurate access.
• 😀 It's important to use a soft tourniquet that doesn’t occlude the radial artery, ensuring proper venous flow.
• 😀 Sterile gloves may make the procedure more difficult, as the practitioner needs excellent tactile sensitivity for small veins.
• 😀 Proper skin preparation and a low-angle insertion technique are key to successful IV line placement in infants.
• 😀 After inserting the catheter, slowly withdraw the needle, leaving the catheter in place, which ensures correct IV line placement.

Q & A

What makes securing an IV in infants more challenging compared to adults?

Infants have smaller veins, excess adipose tissue, and are more likely to move during procedures, all of which make securing an IV line more difficult. Additionally, their veins are more fragile and harder to identify.

Why is it important to choose the right catheter size when inserting an IV in infants?

Choosing the right catheter size, such as a 24-gauge catheter, ensures optimal flow rates and bolus capabilities without causing unnecessary damage to small veins. Larger catheters may fail to secure properly in small infants.

What are the benefits of using a 24-gauge catheter in infants?

A 24-gauge catheter offers the required flow rate and bolus capabilities for a baby weighing 4-5 kg, which is equivalent to an 18-gauge IV in an adult. It's small enough to fit in delicate veins while providing effective fluid delivery.

What are the best sites for placing an IV in an infant?

The best sites for IV placement in infants are the feet, which have large, visible veins, including the saphenous vein. The hands can also be used, but they are more mobile and harder to stabilize.

Why is immobilizing the baby crucial for successful IV insertion?

Infants tend to move during the procedure, making it almost impossible to secure an IV without proper immobilization. Holding the baby still ensures that the vein is accessible and that the procedure can be completed effectively.

How does immobilizing the vein contribute to successful IV insertion?

Stabilizing the vein is key to preventing vein collapse during the insertion of the catheter. By fixing the skin and vein without obstructing blood flow, clinicians can navigate the needle more easily, increasing the chances of successful insertion.

What is the role of transillumination in IV insertion for infants?

Transillumination is used to identify veins that may not be immediately visible. It helps locate veins more clearly, especially in smaller or less developed areas like the hand or foot of an infant.

Why is it necessary to apply a soft tourniquet during the IV insertion procedure?

A soft tourniquet helps to fill the veins with blood, making them more visible and easier to access. It is important that the radial artery is not occluded by the tourniquet, as this could hinder venous flow and make the procedure more difficult.

How should a catheter be inserted to avoid damaging the vein?

The catheter should be inserted at a very low angle and slowly. The insertion should proceed until a 'give' or 'pop' is felt, indicating that the needle has entered the vein. The needle is then slowly withdrawn, leaving the catheter in place to avoid damaging the vein.

What should clinicians avoid when using gloves during IV insertion in infants?

While gloves are recommended for hygiene, they can limit the tactile feedback needed when dealing with small veins. Clinicians should be very gentle and precise to maintain full control over the delicate procedure, avoiding excessive pressure that could collapse the veins.