Vascular Access

There are many ways to obtain venous access in the pediatric patient. The best, in my opinion, is having excellent pediatric EM nurses finding the standard peripheral IV. This, however, isn’t always the case depending on where you are working, and, in select cases you will need to use more advanced access techniques to provide care in your patient. These other options include: Ultrasound guided peripheral IV, umbilical lines in the neonate, and then femoral, subclavian and internal jugular central line access. The following are videos demonstrating all of these techniques.

Neonatal peripheral IV placement from Dr. Al Sacchetti:

US Guided peripheral IV placement:

Cordis Central Line Placement from EM procedures:

Femoral Line Placement from the NEJM:

Subclavian Line Placement from the NEJM:

Internal Jugular Line Placement from oscetube on youtube.com:

IO both manual and EZ-IO placement from the NEJM:

Umbilical line placement from the NEJM. Watch the section on anatomy and placing the tie, and then go to 11:37 into video for placement of an emergent UVC:

The lost art of the Venous Cutdown: