Herbal Spotlight
Clinical Pearls
Infusion Therapy
Geriatric
Considerations
Special Alerts
Medication
Administration
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Inserting I.V. lines in neonatal patients
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- Use a heel warmer to dilate veins.
- Check these major veins in the neonate: dorsal metacarpals in the hand, saphenous vein in the foot, and temporal, frontal, and posterior auricular veins in the scalp.
- Transillumination can be helpful in identifying veins in neonates.
- Use a 24G over-the-needle catheter, 1/2" (1.3 cm) to 5/8" (1.6 cm) length most common
- Obtain assistance to hold the neonate still.
- Take appropriate steps to maintain the neonate's temperature.
- Use minimal tourniquet pressure or no tourniquet at all for fragile veins. A rubber band is an excellent size for use in neonates.
- Clean the site with alcohol. Iodine tincture may affect thyroid function if absorbed through the neonate's thin skin.
- Insert the catheter gently and slowly.
- Expect scant blood return in flashback chamber.
- Pad areas under the catheter hub where a pressure sore might occur.
- Use minimal tape on fragile skin.
- Leave the skin over the cannula tip visible for checking the site.
- Use a transparent neonate-sized dressing for visibility.
- Use a padded tongue blade or rolled gauze as an arm board.
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