Top 10

[details in audio]

1. Set the stage – exude confidence and be prepared

2. Choose the right cannula size – a smaller working IV is infinitely better than none

3. Feeling is better than looking – trust yourself

4. Mark the site – things get wonky when you take your hands off to disinfect

5. Tourniquets can mess you up – try to use a holder’s hand to occlude the vein

6. The holder rules – get as many hands on deck as you need.

7. Tension is good –  a little counter traction on the skin with your non-dominant hand helps to decrease the friction as the needle goes through the fascial layers.

8. Stay in line – your needle is an extension of your arm

9. Gravity is your friend – the kinder, gentler tourniquet

10. The 3 Fs – flash, flatten, and forward. Get the flash at a 30 degree angle, flatten that angle, (advance another 1mm), and advance the plastic catheter over the needle into success

Further episodes of Pediatric Emergency Playbook

Further podcasts by Tim Horeczko, MD, MSCR, FACEP, FAAP

Website of Tim Horeczko, MD, MSCR, FACEP, FAAP