29 Pediatric IV Tricks

Summary

This transcript provides an insightful discussion on the techniques and strategies used in pediatric intravenous (IV) placement, especially when working with children. The speaker, with over 26 years of experience, shares tips on how to hold children still, find veins, and the importance of patient demeanor. They also discuss challenges like dealing with flat veins in dehydrated children and using tourniquets effectively. Additionally, the speaker touches on their preferred IV equipment, such as gel coats and butterflies, and emphasizes confidence and thoroughness when working with pediatric patients and their families.

Takeaways

• 😀 The importance of having a reliable holder when inserting an IV in children to keep them still and avoid injury.
• 😀 Using two tourniquets, one upper and one lower, can help make veins more visible, especially in dehydrated or hard-to-find veins.
• 😀 Gaining a visual and tactile understanding of anatomy is crucial for finding veins, such as the saphenous vein in children.
• 😀 Patience is key when inserting an IV; feeling for a 'give' in the vein is essential before proceeding with the needle.
• 😀 A steady, continuous approach to IV insertion is recommended rather than moving the needle in increments, which can cause discomfort for the child.
• 😀 A rubber band can be used as an alternative to a tourniquet to avoid complications like skin modeling in younger children.
• 😀 Correct positioning of the hand or arm is essential when inserting an IV, particularly in the dorsum of the hand, to stabilize veins and minimize movement.
• 😀 Knowledge of anatomical landmarks and vascular anatomy, especially in the scalp and hands, is necessary to avoid complications like puncturing arteries.
• 😀 When dealing with severely dehydrated patients, using two tourniquets helps improve visibility of veins, but extra patience is required due to slower blood return.
• 😀 Confidence and a calm demeanor are essential when working with pediatric patients and their families, as parents often rely on the caregiver's assurance and professionalism.

Q & A

How many years of experience does the speaker have in putting IVs in children?

The speaker has 26 and a half years of experience working with kids and performing IV insertions.

What is a key strategy when holding a child still during an IV insertion?

The key strategy is to ensure the child’s shoulder is held down firmly. This helps prevent the child from rolling away while the arm or leg is controlled for the IV placement.

How does the speaker handle difficult veins, especially in children who are severely dehydrated?

For hard-to-find veins, the speaker recommends using two tourniquets (one upper, one lower) to cut off circulation and help reveal veins. Patience is crucial as the vein may not bleed back as quickly.

What are the benefits of using a rubber band as a tourniquet?

A rubber band can be used as a tourniquet to help identify veins, especially in children. It also allows for better control as the pressure can be adjusted without causing significant complications like modeling in the skin.

What is the recommended angle for inserting an IV, particularly in babies and children?

The speaker recommends using an angle of about 30 degrees for IV insertion. The angle may vary depending on the patient's age and adipose tissue. In infants with little fat, a flatter angle is preferred.

What is the technique used to stabilize veins when inserting an IV in the hand?

To stabilize veins, the speaker suggests flexing the child’s hand and holding the fingers down while pulling the hand upwards. This tension helps keep the vein in place without causing pain.

How does the speaker feel when inserting an IV, and what is the technique to ensure success?

The speaker relies on a tactile sensation, feeling for a 'give' when entering the vein. Once the vein is located, the speaker inserts the IV steadily without inching to avoid discomfort for the child.

What is the role of a T-connector in pediatric IV care?

A T-connector is used to secure the IV line in pediatric patients, preventing them from pulling out the IV or fluid line while still allowing the IV to function properly.

Why is it important to maintain confidence when performing IV insertions on children?

Confidence is essential as the procedure can be stressful for both the child and the family. The speaker emphasizes not showing nervousness to reassure the family that the procedure will go smoothly.

What is the speaker's stance on using butterfly needles for pediatric IVs?

The speaker notes that while butterfly needles are used for blood draws or pushing medication, they are not ideal for leaving in an IV line, especially in pediatric patients, because the metal construction can cause discomfort when the child moves.