Paediatric venepuncture and peripheral intravenous access — viva

Opening (must-hit)

"Paediatric venepuncture is a single needle puncture to draw blood, while peripheral intravenous cannulation places an indwelling cannula for ongoing therapy. In a child both succeed or fail on the right site, the right comfort and the right operator. I choose the site by age — the dorsal hand veins first, then the antecubital fossa, the forearm and the great saphenous at the ankle — and match the gauge to the child: 24G for the neonate and infant, 22G for the infant and small child, 20G for the older child, 18G for the adolescent or a rapid bolus. I apply a comfort bundle in advance — topical anaesthesia at the correct lead time, sucrose in the infant, distraction and comfort positioning — and I let no operator make more than two attempts. When surface veins fail I use ultrasound-guided access, and in arrest I go straight to intraosseous access." ^{[6] [7] [9]}