I am a nursing student and will be graduating in May. Upon graduation I will go to work for the local hospital on the pediatric floor. As a student we were unable to start IV's on children. Is this a difficult task? And how can I become more comfortable with it before I start my job?
Apr 16, '02
Yes, it can be quite difficult, depending upon the age of the child. It can often require two folks to accomplish-one to hold, one to stick. You can't necessarily rely upon the parent to hold for you.
I would suggest asking for an opportunity at every difficult stick there is, with the smallest veins, in adults. That way you become used to a 22 or 24 ga.
My ER experience with neonates is that their traslucent little kin is usually perfect on the dorsum of the hand, unless some other person has been gouging around before you. Also, the dorsum/akle area of the foot is a good place to look in very young children. I have never done a scalp vein. Older kids are very similar to adults.
Whoever you are sticking, no matter what age, be sure that you explain every step of what you are doing. I think the very youngest ones can tell by the tone of your voice that you are trying to be gentle.
Also, have your tape ready, and get it on quickly. You will probably want to secure the site further with some soft Kerlix proximal and distal, with the site itself exposed.
Good luck, but PLEASE know when to ask for help. I got called from the ER to stick a child that had already had NINE-9!-attempts. The poor little thing had hematomas all up and down its arms. I finally got one, but it sure would've been easier if a couple of earlier people had quit after 1 or 2 negative sticks.
Apr 16, '02
When I first started working with little ones, I was a little leary about sticking them, but in time, I became very comfortable and relaxed with the procedure of starting IV's on them. Don't expect to not be nervous or anxious your first few tries because you will be. Just pay close attention to your Preceptor's instructions, observe how others perform IV's on the little ones, and practice what you are taught by the really good IV starters.