Whenever possible, butterfly over angiocath if your facility has them. I find butterfly IVs much easier to thread into little spaghetti veins. Also, thinking like a child goes a long way when interacting with them. Don't tower over them, use language they can understand (blow out birthday candles as an example to get them to take a deep breath). If they are old enough to understand choices, give them one. Use mommy or daddy to demo things they're going to be afraid of. Let them listen to your heart first. Don't lie to them. This is difficult, especially when you have to do things you know will cause pain. I always get asked if the IV will hurt, and I find something to compare it to...i.e. has your brother/sister ever pinched you? Have you ever been stung by a bee (it hurts less than that!)? And finally, a quiet kid is a kid you don't let out of your sight for long. Screaming, kicking, fighting? Fantastic. Pale and quiet? You better keep a close eye on vitals and make sure they're hydrated. Pedi ER patients are my absolute favorite. Once you feel comfortable with the truly sick ones (which are less than 10% of your entire pedi population) then the rest is cake!