In our ED (NSW, Australia), we are encouraged to always insert 18 gauge intravenous cannulas. I have read that this could increase the chance of infection and irritation to the vein. I usually pop a 18 gauge in, however of course this is not always possible, what are your recommendations re gauge of IVC. Also I feel we tend to go "over the top" with IV cannulas and blood testing. If you score a bed in our ED you usually get cannulated, pathology tested and usually score some sort of xray, scan etc. Is it because of fear of litigation? Or are doctors becoming less skillfull on hands on assessment/diagnosis?