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Neonatology clinic in Yeshwanthpur, Bangalore

Peripheral Catheter Insertion

Neonatology clinic in Yeshwanthpur, Bangalore

Peripheral catheter insertion is the process of inserting an intravenous (IV) line into the vein where a cannula (thin tube) is placed inside the vein for venous access. As premature and sick infants might stay longer at the hospital, they may undergo multiple cannulations in the NICU as a part of neonatal resuscitation. So, the peripheral veins are the preferred vein sites. However, doctors will ensure not to re-cannulate the already cannulated veins for the protection of the baby. Visit our neonatology hospital in Yeshwanthpur for the best treatment.

The peripheral intravenous line (PIV - small, short, and flexible tube) is inserted into the preferred areas such as the hand, foot, leg, wrist, etc. This PIV is used to give fluids, nutrients and medicines to a baby through IV. If the PIV is not successful, then Umbilical Vein Catheterisation (UVC) procedure is used to make sure the baby is healthy by giving fluids and medicines through this umbilical venous catheter. PIV might not be possible for some babies who are very sick, small or chubby. Sometimes It gets hard to insert PIV, and then the UVC procedure is used. 

Common vein areas preferred for IV cannulation: 

  • Hands

The first preferred veins for IV cannulation are dorsal arch veins that are easily seen on the back of the infant's hands. These veins are usually larger, and IVs cannulated here can be easily secured and splinted. Any infiltration (leakage of IV fluid into the skin from the PIV slipped out of the vein) can also be easily spotted. The second option can be the cephalic vein which is large, and cannulation in this vein also lasts long. 

  • Cubital Fossa

Cephalic, median cubital, and basilic veins are the main veins where cannulation lasts long if secured properly. In case of infant needs long-term IV therapy, then these veins are avoided. 

  • Wrist

Easy secondary spot for IV. However, the cannulation done on the volar side can be easy but does not last long. 

  • Foot

Dorsal arch veins and veins going up to short saphenous are preferred options. 

  • Leg

Veins in the leg area are avoided if the infant needs percutaneous central venous catheters and long-term IV therapy. The saphenous veins at the knee are easy to access, and cannulation lasts long here. 

  • Scalp

When all the above possibilities are not successful, then superficial temporal veins near the scalp are used for IV. 

Pre-Procedure: 

When the baby is made comfortable, the neonatal doctor will thoroughly examine the baby's vein spots and choose the best possible vein site for IV cannulation. The vein which is straight, easy to access, stands up a little and is easy to secure is preferred by the doctor. Book an appointment to consult with the experts.

Procedure: 

  • PIV procedure is performed by a certified and trained medical doctor or registered nurse.

  • Pain-relief options are given to the baby if needed. 

  • Once the preferred vein is identified and secured, the needle is inserted straight along the vein with less pain caused to the baby.

  • Once the blood appears, the cannula is then secured in that vein area. 

  • After confirming the PIV is in the right position, the needle is taken out, and a catheter or cannula will stay inside the vein to provide fluids and nutrition to the baby.

Risks: 

Most of the complications can be prevented by proper usage of an IV cannula. The PIV will last for 1 to 3 days before the new PIV is required. Therefore, for every 48 to 72 hrs, a new IV cannula is to be used. The risk of infiltration is also possible, which causes the IV site to look puffy, and red and the skin also gets irritated. Doctors will immediately treat irritated skin with proper medicine to prevent long-term skin damage. For babies depending on the long-term IV fluids and medicines, then a midline catheter or percutaneously inserted central catheter (PICC) is used, which can last for 2 to 3 weeks longer.

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