Inserting an IV
An IV is a fine tube inserted in a vein in the hand, arm or foot to deliver fluids and medicine into the bloodstream.
A doctor or nurse can insert an IV. Many hospitals have an “IV team” of nurses and technicians highly skilled in this procedure.
The procedure can be challenging for young children – the tips below will help make the process easier and less stressful.
During the Procedure
A tourniquet (tight band) is placed above the site to make the veins larger and easier to find. The nurse feels the vein and cleans the area with an antiseptic.
A needle is then inserted to guide the fine tube into place. This IV tube is most commonly called a cannula, but is also known as a branula or venflon.
If a topical anaesthetic is not used, your child will feel a short sharp scratch as the needle punctures the skin, and some pressure as it enters the vein.
The needle is withdrawn, leaving the tube inside the vein. The cannula is secured with a clear adhesive dressing and soft bandage.
Removing the IV
Infused liquids can sometimes enter tissue under the skin, causing them to become swollen, red and sore. If this happens, the cannula will be removed and a new one inserted at another site.
An adhesive remover gel can make removing the clear dressing less painful. When the tube is removed, applying gentle pressure above the insertion point prevents bruising and bleeding. A small pad will then be taped over the site.
Over time, your child’s veins may become sensitive or sore. Tell the doctor or nurse if this happens so these areas can be avoided when looking for a vein.
Finding veins can be difficult, especially if your child has had many IVs or is very nervous or malnourished. Here are some tips to help.
Blood vessels constrict with stress. Blowing bubbles regulates breathing and calms the body. Your presence can also be very calming.
Use a Position of Comfort
Having your child sit with you, in a familiar comfort hold will help her feel supported during insertion of the IV. Positions of comfort also allow you to gently “hug” your child during the procedure and can keep the other limbs from moving too much. Practice the different positions with your child ahead of time to determine which position works best and feels most comfortable.
Keep Hands Warm
Blood vessels constrict when hands are cold. Encourage your child to wear gloves, or place both hands in warm water. Use a hot water bottle or a surgical glove filled with hot water, wrapped in a blanket around the hands.
Dehydration diminishes fluid in the veins. Encourage your child to drink before the IV is inserted. This will make veins bigger.
Encourage your child to swing her arms to increase blood circulation to the hands. Hanging arms down will also enlarge veins in the hands.
A cream, gel or spray can be applied to numb the skin. Check the required timing to ensure full effect. Some anaesthetics constrict veins. Ask your nurse for advice and experiment to find what works best for your child.
Topical anaesthetics are not recommended when inserting an IV to give medications that can bum the skin if they leak. This is because inability to feel the burning sensation will prevent you being alerted to the leakage.
Take a Break
If your child becomes distressed, request a break, or even a different nurse. Your child should never be held down for this procedure – there are many ways to support a child through IV insertion without resorting to forceful restraint.