Difficulties Related to Peripheral Intravenous Access in Children in an Emergency Room

Abstract

This prospective study examined the characteristics of children admitted to a pediatric emergency department and the factors that influenced the successful establishment of peripheral intravenous (IV) access. Descriptive and correlational analysis was completed using a convenience sample of 89 patients. Peripheral IV access was successful in 95.7% of the children, and the first attempt at insertion was successful in 53% of the procedures. Factors influencing the success of peripheral IV access were the patient's gender, skin color, presence of difficult-to-see veins, small veins, presence of fever, and a lack of palpable veins.

Evaluation of the difficulty of peripheral venous cannulation during anesthesia induction in children: Is DIVA score sufficient?

“…Several successive studies validated the DIVA score in different populations, and the PIVA procedure was performed mostly by staff nurses at emergency department settings. 4,9,10…”

“…A literature survey revealed that all of these studies regarding DIVA have been conducted at pediatric emergency department or pediatric clinics, which is the main drawback of these reports. 4,9,10…”

“…Excluding so-called beginner period attempts which results in 25%-50% failure rate, PIVA attempts are almost always successful. [2][3][4][5][6] But majority of these patients require two or more attempts to establish a sound PIVA. 7 Multiple attempts to establish a successful PIVA may lead to some problems including lifelong needle fear in the child, a negative quality perception about the institution and the care delivered to patients' parents, unnecessary distress for the practicing health-care worker and increased possibility of medical complications.…”

“…A literature survey revealed that all of these studies regarding DIVA have been conducted at pediatric emergency department or pediatric clinics, which is the main drawback of these reports. 4,9,10 In this study we aimed to determine the rate and the independent predictors of difficult PIVA procedures in the operating room and also to assess the ability of the DIVA prediction rules in identification of difficult PIVA cases in the operating room. To our best of knowledge this is the first DIVA score prediction analysis study performed in pediatric surgery cases.…”

The effect of the use of the ultrasound-assisted technique versus traditional anatomic landmark approach for the saphenous venous cannulation in infants and toddlers with congenital heart disease: a randomized controlled trial

“…Considering the characteristics of poor nutritional status, younger age, and lousy peripheral venous circulation, obtaining venous access can be challenging in children with cardiac anomalies. Cyanotic children are, in particular, tough to deal with [4][5][6]. Also, several articles [7,8] had reported an apparent high prevalence of Ehlers-Danlos syndrome, a severe heritable disorder of connective tissue in complex congenital heart defects, which may further deteriorate the peripheral venous conditions.…”