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Emergency Pediatric Vascular Access

Vascular access is often needed for pediatric patients being treated in the emergency department. Access is often required to evaluate for acute metabolic emergencies, assess for infectious emergencies, to provide fluid resuscitation, blood product and medication administration. Obtaining vascular access can be a challenge, particularly in young children with small vessels and in critical conditions with dehydration or poor perfusion. The method, site, and size of device used to obtain vascular access primarily depend on the patient’s clinical status, the agent to be administered as well as parental preference. Anatomical differences considering the smaller vessels in pediatric patients and patient discomforts and fear of needle sticks afford challenges that are unique to this population. In addition, it is imperative that the emergency physician is cognizant and has strategies to treat both the child’s and the parent’s anxiety associated with the procedure. The emergency physician should have a level of comfort and knowledge of the various techniques and sites of access that are used for pediatric emergencies.