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brendajw1
IV's in toddler's feet
Do you start peripheral IV's in a toddlers foot if they are able to walk?
Heather Nichols
   No, you should not. 
   No, you should not.  Higher risk for infection and DVT from the lower ext.  If you are thinking about placing PIV's in the foot, maybe you should re-assess the patient for central access of some kind.  Foot IV's are pretty extreme, and also dangerous.  Toddlers get into everything.  How would you keep him/her away from it? You can barely keep shoes on the little tykes.  They also kick, jump, play, and more.  Bad idea if you ask me.
Anne Marie Frey
Actually, you can

Actually, you can technically place IVs in a toddler's feet, but the issue is more trying to keep the child immobile and keep them from dislodging the line.  Published evidence shows that children reach adult rates of phlebitis [hence thrombophlebitis and DVT risk] after 10 years of age.  PIVs are very low risk of infection, but with enough movement and manipulation, it certainly could be a risk, but I don't know of reported evidence in children that foot sites get infected more than other sites.  So, for example, in a walking toddler, we won't place and IV because it is impossible to keep them from walking on it.  In a toddler who is immoblie because of sedation or disease state, we sometimes will use the feet.

Anne Marie Frey RN, BSN, CRNI

Clinical Nurse Level Four

Vascular Access Service: I.V. Team

The Children's Hospital of Philadelphia

Anne Marie Frey RN, BSN, CRNI, VA-BC
Clinical Expert
Vascular Access Service: I.V. Team
The Children's Hospital of Philadelphia
[email protected]

lynncrni
I totally agree that the

I totally agree that the feet of walking children should not be used for a PIV site. From my perspective, the risk is not infection but infiltration/extravasation injury. Remember, the drug itself and its potential for tissue damage is not the only factor to consider. Large amounts of fluid alone can lead to serious damage from compartment syndrome. So the risk are far too great unless the child is sedated or bedridden for some reason. 

Lynn Hadaway, M.Ed., RN, BC, CRNI

www.hadawayassociates.com

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

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