Paeds Cases · investigations-procedures-and-technology
Paediatric venepuncture and peripheral intravenous access — OSCE
OSCE assessment and procedural-planning station for a dehydrated toddler requiring peripheral intravenous access, with a structured oral of site and gauge selection, the comfort bundle, ultrasound escalation and complication management.
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Target exams
MRCPCH ClinicalRACP DCE
Prompt
You have 9 minutes with a dehydrated 18-month-old who needs a peripheral cannula for rehydration. State your site and gauge, apply the comfort bundle, describe the cannulation sequence, and explain how you would escalate if the first attempt fails.
Station brief (candidate)
- State the cannulation site you would choose and the order of sites, and justify starting distally on the hand.
- State the cannula gauge for this child and the principle behind gauge selection.
- Describe the comfort bundle you would apply, naming the topical agents and their lead times.
- Outline the cannulation sequence and how you would confirm correct placement.
- Explain your escalation pathway if the first attempt fails, including the role of ultrasound and the attempt rule. [6] [7]
References4ShowHide
- [1]Bair AE, Rose JS, Vance CW, et al. Ultrasound-assisted peripheral venous access in young children: a randomized controlled trial and pilot feasibility study. West J Emerg Med, 2008.PMID 19561750
- [6]Ray-Barruel G, Pather P, Schults JA, et al. Handheld ultrasound devices for peripheral intravenous cannulation: a scoping review. J Infus Nurs, 2024.PMID 38422403
- [7]Russell SC, Doyle E. A risk-benefit assessment of topical percutaneous local anaesthetics in children. Drug Saf, 1997.PMID 9113495
- [10]Cavicchiolo ME, Daverio M, Battajon N, Frigo AC, Lago P. A single dose of oral sucrose is enough to control pain during venipuncture: a randomized clinical trial. Front Pain Res, 2022.PMID 35634454