Summary

Difficult IV access is a common issue faced in the pediatric patients and ultrasound guidance improves success and efficiency over the traditional land marking approaches. A dynamic approach is preferred, and the choice of out-of-plane vs in-plane technique is operator dependent. The ideal vessel for USG PIV placement is greater than 0.4cm in diameter, between 0.3 and 1.5cm in depth and at least 1cm in length. Long catheters are preferred to increase longevity.

 

Remember:

1. Prepare: Gather your equipment
2. Optimize: Position, tourniquet, warm compress, and local anesthetic
3. Identify: Select a target vessel. Confirm it is venous looking at wall thickness and compressibility
4. Poke: Introduce the needle and follow the tip through its course from the skin into the vessel
5. Confirm: Confirm catheter placement and secure it to the patient