Our vascular access team, some ED nurses and some ED pysicans at our hospital all place ultrasound guided peripheral catheters. Recently, the vascular access nurses were called to assist with a difficult access on 2 year old in the ED. On arrival the patient was having seizures and the nurses recommended an IO immediately. There were 3 MD's present one who agreed with the vascular nurses. One MD was trying to scan the patient with ultrasound for a suitable vein and the other MD present was encouraging her to do so. Long story short, the MD found the femoral vein and placed a BD 1.88in long peripheral catheter. I brought this to the attention of the quality department. The ED PI specialist spoke with the ED medical director who told her that this is a new and accepted procedure. I am a member of INS and AVA and hold my CRNI. I was dumbfounded that I hadn't heard of it. I also looked in our hospital's clinical decision support program, UpToDate, and do not find it anywhere in the pediatric access algorithm. I think the PI was told this to shut the subject down. I plan to speak with the physician now myself. I want to make sure I am not missing something that mght be new. Is anyone placing peripheral lines in the femoral vein, pediatric or otherwise, and do you have some evidence for it? It doesn't seem right to me, the femoral vein is generally thought of as a central vein and I don't think a 1.88 inch peripheral catheter would be centrally place on a 2 year old. No x-ray was done.