Children’s Hospital of The King’s Daughters |
What is an “IV”?
“IV” stands for “intravenous,” which means inside the vein. Fluids and medicines are often given into the veins through a catheter (a hollow plastic tube). Once the catheter is in the vein, the needle is removed. Sometimes a different type of IV, called a butterfly, is used for medications that are given once over a short period of time. The butterfly IV needle stays in the vein until the IV medication dose is completed. The IV catheter is joined by tubing to a bag or bottle of medicine, fluid, or blood. The tubing may also be attached to a special machine that pumps the fluid into the vein at a set rate.
Infants often have IVs put in the hand, arm, foot, or scalp. Children and teens often have the IV in the hand or arm. The nurse will decide the best place for your child. After the IV has been put in the vein, your child’s nurse will tape it to help keep it in place. Keeping your child’s arm or foot still may help the IV stay in place. Your child’s hand or foot may be taped to a special padded board to keep the IV from coming out. Sometimes infants and small children may need a device on their other arm or foot to keep them from pulling the IV out.
Why do some patients need an “IV”?
- Some medicines can only be given by IV.
- Some medicines do not work well when given by mouth.
- Some medicines work faster when given by IV.
- Sometimes an IV can be used instead of shots into the arm or leg.
- When your child cannot eat or drink because of certain tests, surgery, or if your child’s stomach is upset, an IV is often the only way to give medicine and fluids.
How is the “IV” put into the vein?
When your child’s doctor decides that an IV is needed, the nurse or clinician will put the IV in place. The child is often taken to the treatment room for this. Other staff members may also be there to help hold and comfort your child. Child Life team members may be available to help prepare your child for procedures.
Once the IV site is chosen, a numbing/cooling spray or a Lidocaine (numbing) cream may be used in preparation for the needle-stick to help decrease the pain or discomfort. The spray works very quickly, while the cream works 30-45 minutes after it is applied. There are emergencies when IVs have to be started quickly and this type of preparation may not be possible. We will provide comfort measures without these medications in those situations.
Before the needle stick is done, the site will be cleaned with an antiseptic solution. When the skin is first punctured, it will hurt a little. A small IV tube is left in the arm or leg when the needle is removed so the fluid can get into the vein. There should be little or no pain after the needle is removed. After your child’s nurse or clinician is sure the IV is in the vein, he/she will tape it in place.
Drawing blood and starting an IV can hurt for a short time. It may take the person starting the IV more than one try to get it. The staff will be careful to help your child keep still and stay as comfortable as possible. For some younger children, the fear of the needle-stick is more worrisome than the actual pain of the stick. Child Life team members may be available to help prepare for procedures.
What can parents do to help?
Some parents want to stay in the room during the needle stick and some parents choose to leave. Either way is ok! If you choose to stay in the room, you might want to help turn your child’s attention away from the needle-stick. Here are some suggestions:
- Tell stories
- Make funny faces at each other
- Talk about your favorite subject at school
- Take deep breaths
- Sing or talk softly
- Say or do something that you do at home when your child needs help staying calm
- Grab hands and squeeze as hard as you can
- Rub your child’s arm or leg
- If you decide to leave the room, please remember that someone will be with your child to comfort them. You may return right after the needlestick is done or the IV is started.
- It is helpful to tell the staff what types of things work to help calm your child.
Taking care of your child’s “IV”
- The place where the catheter goes through the skin will be checked often by your child’s nurse.
- Sometimes IVs slip out of the vein and the fluid may make the skin puffy and red. If your child pulls at his IV site, steps on his IV tubing or if IV tubing gets caught on the bed rails, please let us know as these actions could cause the IV to come out of the vein. Some IV fluids and medications can also irritate veins and cause pain, tenderness, and redness of the area. Some of these problems cannot be prevented, but we will check your child’s IV frequently to catch problems early. If you notice redness, swelling or pain at your child’s IV site before we do, call the nurse right away.
- Your child may require another IV restarted in a new vein if the existing catheter is removed.
- Your child’s doctor will decide how long the IV is needed.
- When the IV is no longer necessary, it can be easily removed.
What if my child needs an IV for a long time, or the IV has to be replaced several times?
Your child’s doctor may choose to order a “midline” or “PICC line” to replace the IV that your child has now. Your child’s nurse will give you the Way to Grow handout #0474 for PICC or Midline Placement as needed. Our Vascular Access Team has specially trained nurses who perform this procedure. They will talk with you and your physician about a plan for pain control or sedation during this procedure.
Remember, call your child’s nurse if:
- Your child cries and you cannot comfort him/her.
- Your child complains of pain around the area where the IV is inserted.
- The IV site is red or puffy.
- You see your child pulling on the tubing or if the tubing gets stepped on or caught on something.
- The IV pump alarms.