Scalp Vein Sets in Pediatric Medicine
Scalp Vein Sets in Pediatric Medicine
Scalp vein sets, also known as butterfly needles or winged infusion sets, are essential vascular access devices in pediatric medicine, particularly useful in neonates and infants where peripheral access can be challenging.
Key Points:
- Short-term vascular access device
- Available in various gauges (21-27G)
- Flexible wings for secure fixation
- Ideal for difficult venous access situations
- Suitable for both blood sampling and infusion
Scalp Vein Anatomy
- Major Scalp Veins
- Superficial temporal vein
- Posterior auricular vein
- Occipital vein
- Supratrochlear vein
- Supraorbital vein
- Anatomical Advantages
- Superficial location
- Good visibility
- Minimal subcutaneous tissue
- Relatively fixed position
- Good blood flow
Specifications and Selection
- Gauge Sizes
- 27G: Extremely premature infants
- 25G: Premature infants and small neonates
- 23G: Term neonates and young infants
- 21G: Older infants and small children
- Components
- Stainless steel needle
- Flexible wings
- Extension tubing
- Luer lock/slip connection
- Safety mechanism
Flow Rates
- 27G: ~9-10 mL/min
- 25G: ~15-17 mL/min
- 23G: ~30-35 mL/min
- 21G: ~65-70 mL/min
Common Indications
- Primary Indications
- Difficult peripheral access
- Short-term IV therapy
- Blood sampling
- Emergency vascular access
- Specific Situations
- Neonatal intensive care
- Exchange transfusion
- Emergency fluid resuscitation
- Medication administration
- Contraindications
- Local skin infection
- Scalp hematoma
- Caput succedaneum
- Suspected skull fracture
Insertion Procedure
- Preparation
- Select appropriate site and gauge
- Position patient appropriately
- Gather necessary equipment
- Shave area if necessary
- Site Selection
- Identify suitable vein
- Avoid areas of trauma/infection
- Consider distance from fontanelle
- Check vein patency
- Insertion Steps
- Clean site with appropriate antiseptic
- Allow to dry completely
- Apply tourniquet if needed
- Hold wings with dominant hand
- Insert at 15-30 degree angle
- Look for flashback
- Decrease angle and advance slightly
- Secure properly
Potential Complications
- Immediate Complications
- Bleeding/Hematoma formation
- Arterial puncture
- Failed insertion
- Pain/Discomfort
- Early Complications
- Infiltration/Extravasation
- Phlebitis
- Thrombophlebitis
- Infection at insertion site
- Late Complications
- Catheter-related bloodstream infection
- Thrombosis
- Skin necrosis
- Scarring
Maintenance & Care
- Site Care
- Regular inspection (every 1-2 hours)
- Keep dressing clean and dry
- Monitor for signs of infiltration
- Check patency before each use
- Duration Guidelines
- Replace every 24-72 hours
- Remove if signs of complications
- Document duration of use
- Infusion Management
- Use appropriate flow rates
- Regular flushing protocol
- Compatible medication checking
- Proper securing technique
Documentation Requirements
- Insertion date and time
- Gauge size and location
- Number of attempts
- Complications if any
- Daily site assessment
- Removal date and reason
