Pediatric IV Cannulas

Neonates (0-28 days)
- 24G (Yellow): Primary choice
- 26G (Purple): Extremely low birth weight
- Flow rate: 22-19 mL/min
- Best for peripheral veins
Infants (1-12 months)
- 24G (Yellow): Standard use
- 22G (Blue): Larger infants
- Flow rate: 22-36 mL/min
- Suitable for most therapies
Children (1-12 years)
- 22G (Blue): Primary choice
- 20G (Pink): Larger children/Emergency
- Flow rate: 36-60 mL/min
- Blood sampling capability

Standard Peripheral
- Straight design
- With/without wings
- Various port options
- Safety mechanisms
Safety Devices
- Needle-stick protection
- Blood spillage prevention
- Auto-retractable needle
- Visibility chamber
Special Features
- Extended dwell time
- Integration ports
- Pressure injection compatibility
- CT/MRI compatible options

Emergency Situations
- Fluid resuscitation
- Emergency medications
- Blood product administration
- Rapid sequence induction
Routine Care
- IV medications
- Maintenance fluids
- Perioperative management
- Nutritional support

Preferred Sites by Age
- Neonates:
  - Dorsum of hand
  - Forearm veins
  - Antecubital veins (last resort)
  - Scalp veins (if necessary)
- Infants/Children:
  - Dorsum of hand (first choice)
  - Forearm veins
  - Foot veins (ambulatory status)
  - Antecubital (emergency only)

Preparation
- Pain management options:
  - EMLA cream (60 min prior)
  - Local anesthetic
  - Distraction techniques
  - Child life specialist
- Equipment needed:
  - Appropriate size cannula
  - Tourniquet
  - Cleaning solution
  - Securing devices
Step-by-Step Technique
- 1. Vein identification
  - Transillumination device
  - Warm compress application
  - Gravity dependent positioning
  - Gentle tapping
- 2. Insertion technique
  - 15-30 degree angle
  - Bevel up position
  - Flash observation
  - Advancement steps

Daily Assessment
- Site inspection every 2-4 hours
- Dressing integrity check
- Patency verification
- Documentation requirements
Flushing Protocol
- Normal saline:
- Neonates: 0.5-1mL
- Infants: 1-2mL
- Children: 2-5mL
- Frequency: Q8h or PRN

Early Complications
- Infiltration/Extravasation:
  - Immediate removal
  - Elevation
  - Cold/hot compress
  - Documentation
- Phlebitis:
  - Remove catheter
  - Grade assessment
  - Treatment plan
  - Monitoring protocol
Prevention Strategies
- Regular site rotation
- Proper securement
- Aseptic technique
- Documentation compliance

Recommended Timeline
- Neonates: 72-96 hours
- Pediatric: 72 hours
- Emergency insertion: 24 hours
- Earlier if complications
Removal Criteria
- Signs of infection
- Complete therapy
- Malfunction
- Patient discomfort

Pediatric Intra-Venous Cannulas