Failed intravenous access in children

Tremlett, Michael; Bajwa, Samira

doi:10.1016/j.mpaic.2008.10.008

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Volume 10, Issue 2 , Pages 87-92, February 2009

Failed intravenous access in children

Michael Tremlett, BM, DCH, FRCA, is a Consultant Paediatric Anaesthetist at the James Cook University Hospital, Middlesbrough, UK. He qualified from the University of Southampton, and trained in the South West and North of England, and Johns Hopkins Hospital, Baltimore, USA. His research interest is sleep disordered breathing in children. Conflicts of interests: none declared

Samira Bajwa, MBBS, FRCA, is currently a Senior Registrar in Paediatric Anaesthesia at the Women and Children’s Hospital in Adelaide, Australia. She completed her medical degree from King Edward Medical College in Lahore, Pakistan. She is on the Specialist Registrar training programme in the North East of England. Conflicts of interests: none declared

Abstract

Securing intravenous access in children can, on occasion, be difficult, time-consuming and frustrating. Unhurried preoperative examination for possible cannulation sites, avoidance of long starvation times and the use of adjuncts including topical local anaesthetic creams and oral sedatives improve success rates. Despite these measures, failure of peripheral cannulation will still occur. A range of alternative methods to access the circulation including intraosseous needles and central venous cannulation are described in outline. The role of each alternative technique in a range of clinical situations is discussed along with their advantages and disadvantages.

Keywords: cannulation – intravenous, children, intraosseous