Who uses scalp veins in babies?

SmilingBluEyes · Dec 24, 2003

We ROUTINELY use scalp veins on newborns in our nursery. I would think IF needed, they could be in ER on 16 month olds, as well. WHY put a child thru several failed sticks, if one vein is that prominent? Remember, too even though not "scary sick"that baby could have been dehydrated and therefore, peripheral veins harder to cannulate.

That said, protecting ANY IV site on a child that age is a challenge,and I would think a scalp vein, especially so.

athomas91 · Dec 24, 2003

most of the hospitals i have worked in "as policy" don't allow the ER nurses to use the scalp veins - probably just due to the fact we don't do it much - we usually call the nursery or the np on up in the nursery to do those...

Dave ARNP · Dec 24, 2003

I've never heard ANYONE question using scalp veins in a little one. Those little veins are hard enough to find, and when they are in a position that they NEED an IV, it's usually harder.

HOWEVER, rarely does anyone in our hospital do one unless they are a ped's nurse. Most of our nurses think they look so pitiful with one, and "Hate to do that to such a tiny little person". So, rather than try it and not get it perfect the 1st time, they get a ped's nurse in to do it, as they handle them more often.

Interesting point though, had never thought of it.

And BTW, no one has to ask permission to do one.

Dave

Mimi2RN, ASN, RN · Dec 24, 2003

I would rather do one good stick in a scalp vein, than subject a baby to several other sticks elsewhere. Some nurses don't like to do them, so they'll tell me it's mine.............. We don't have to ask permission, either.

BarbPick · Dec 24, 2003

Newborns are the only ones I use a scalp vein on. I use a #24 insyte cath in the scalp. I put PICC lines in a newborn's wrist. I use the foot up to Two years of age. I use the two notch veins between the wrist bones on all children as a blind stick, just above a bent down wrist on "chubby " little hands.

It is a good idea to practice these areas of vascular access on your friend or roommates, just look but don't stick. The more you practice finding them, the easier it will be at crunch time.

Barbara, my first certification is CRNI .

SpnshEyes1975 · Dec 26, 2003

When I worked at a Childrens Hospital, it was quite common to use scalp veins on the younger babies, but since I came to the ER, I've only seen it once. I guess it just depends on your specialty and talent! :ROTFL:

Rachael

teeituptom, BSN, RN · Dec 26, 2003

As a long time ER worker, we use scalp veins if needed. it still is preferable then some MD sticking in an intraosseous line

Trauma Columnist · Dec 26, 2003

I work in the ER and we routinely stick heads, feet, whatever else we need to in order to get IV access.

veetach · Dec 29, 2003

I have worked in various ED's over the last 8 years, and have no problem sticking a foot. However I have only seen docs use scalp veins. If we cant get the IV in the ER, we usually leave the scalp veins for the peds nurses to try. We dont have to have permission either.

BarbPick · Dec 29, 2003

Thinking more about this, I will never use a scalp vein at home. If a mom spikes a fever in Labor, the baby is put on 10 days of gent and ampicillin, 7 of which are done at home.

Mom doesn't need to see a scalp vein infiltrate and have the baby's eye become puffy, I always D/c the scalp vein and and put in a peripheral cath.

Jolie, BSN · Dec 29, 2003

With a NICU background, I come from the "any port in a storm" school of thought on infant IVs.

Scalp IVs are upsetting (for parents) to look at, especially if they require any shaving. However, from the baby's perspective, they are typically well-tolerated. The veins tend to be a little larger and more resilient than other peripheral sites. And they leave the baby's extremities free. Babies object to having their little extremities restrained. When it is necessary to restrain a hand or arm to protect an IV site, the baby loses out on 2 important means of self comfort, ie sucking and flexed posturing.