Pediatric IV and Catheter Considerations

Vein visualization tools like ultrasound, transillumination, or near-infrared technology help identify the best vein for IV placement, ensuring success and minimizing discomfort.

Using assistive vein visualization devices improves the chances of successful IV insertion in children especially since their veins are small and harder to locate.

Midline catheters are ideal for infusions lasting more than 6 days, allowing for longer-term medication administration without frequent needle sticks.

Avoid placing a midline catheter in an injured arm, an arm with an A/V fistula, or a patient with chronic kidney disease, as these conditions can hinder proper function and increase complications.

The basilic, brachial, or cephalic veins in the upper arm are preferred for midline catheter placement due to their size, accessibility, and proximity to the heart.

Never trim a PICC for midline placement, as it can cause confusion about the type of device and position the catheter tip outside the SVC, potentially leading to complications.

Adhering to aseptic non-touch technique, appropriate skin antisepsis, and maximum sterile barrier precautions is crucial during midline catheter insertion to minimize infection risks.

Using a sterile procedural insertion tray, ultrasound equipment for visualization and access, and normal saline flush solution ensures that all the necessary components are readily available for a safe and efficient midline catheter placement procedure.

The smallest catheter size that can be used in a specific vein, ensuring minimal damage and appropriate flow.

A central venous access device inserted into a large vein in the arm and advanced to the superior vena cava.

The ideal location for inserting a midline catheter in adults. It minimizes risk of complications and ensures proper line placement.

The tip of a midline catheter should ideally be located at or proximal to the axillary line (shoulder area) and distal to the shoulder joint. This placement minimizes risk of complications and ensures effective drug delivery.

A central venous access device inserted into a large vein in the arm and advanced to the superior vena cava, requiring a specific technique and placement for long-term use.

The most ideal location for inserting a PICC. It minimizes the risk of complications and allows for ease of access.

A type of central venous access device that is placed through a needle into a large vein and then advanced to the superior vena cava.

A specific type of central venous access device that is used for short to long-term central venous access. They are not preferred for emergent access situations.

Relative contraindications are factors that may increase the risk of complications when using a device or performing a procedure, but do not absolutely prevent its use. In the context of central venous access, examples of relative contraindications include the presence of an automatic implantable cardioverter defibrillator (AICD), a pacemaker, and implanted neurostimulators.

The upper extremity, including sites like the basilic, brachial, and cephalic veins in the arm, are preferred locations for placing a peripherally inserted central catheter (PICC). The insertion site should be chosen based on the patient's anatomy and the intended use of the PICC.

The optimal tip location for a central venous catheter (CVC) inserted in the upper extremity, subclavian, or axillary veins is the lower third of the superior vena cava (SVC) or the cavo-atrial junction (CAJ/upper right atrium RA).

The inferior vena cava (IVC) above the level of the diaphragm is the optimal tip location for a CVC placed through the femoral vein. This positioning ensures that the catheter tip is in the correct location for effective medication delivery and to avoid complications.

Aseptic technique is essential for all IV-related procedures, especially those requiring central venous access. Sterile gloves and aseptic technique during the insertion of a central venous catheter minimize the risk of infection. This involves using sterile supplies, carefully preparing the skin using antiseptic solutions, and maintaining a sterile field throughout the procedure.

A midline catheter is a central venous access device inserted into a large vein in the arm, usually in the basilic, brachial, or cephalic veins. The tip is placed in the superior vena cava (SVC), allowing for long-term infusion therapy.

Midline catheters are ideal for patients who require long-term IV therapy (more than 6 days) but don't need the complexity of a central line.

The optimal insertion site for a midline catheter in adults is the middle third of the upper arm, at least 2 inches above the antecubital fossa (the bend in the elbow).

The tip of a midline catheter should ideally be positioned at or proximal to the axillary line (shoulder area) and distal to the shoulder joint, ensuring proper location and function for medication administration.

The smallest catheter size should be used in the vein, ensuring minimal damage and appropriate flow of medication.

Aseptic non-touch technique, appropriate skin antisepsis, and maximum sterile barrier precautions are essential during midline catheter insertion to minimize infection risks.

Midline catheters are NOT central lines, and patients and caregivers should be educated to communicate the device type to healthcare professionals to avoid accidental misuse.

Vein visualization tools like ultrasound, transillumination, or near-infrared technology are crucial for identifying the best vein for IV placement in children, ensuring success and minimizing discomfort. They help visualize the veins, aiding in the selection of the most appropriate vein for IV placement.

The superficial temporal, frontal, occipital, post auricular, and external jugular veins in the scalp are preferred for IV placement in infants less than 18 months old. These veins are accessible and suitable for infants' delicate features.

Metatarsal veins in the foot and saphenous veins in the leg are suitable IV sites for infants before they start walking and crawling. These veins are less likely to be damaged by movement.

Midline catheters are ideal for infusions lasting more than 6 days, allowing for long-term medication administration without frequent needle sticks. They provide a stable vascular access for extended therapy.

The optimal tip location for CVCs inserted in the upper extremity, subclavian, or axillary veins is the lower third of the SVC or the CAJ/upper RA.