Related Experiment Video
Updated: May 8, 2026
Computed Tomography (CT) Guided Implantation of a Totally Implantable Venous Access Port (TIVAP) through Subclavian Vein
Published on: January 13, 2026
Prehospital peripheral intravenous vascular access success rates in children
Lucas A Myers1, Grace M Arteaga, Logan J Kolb
1Gold Cross, USA.
Insights
Prehospital pediatric peripheral intravenous (PIV) access is challenging, especially for young children. Success rates increase with age, highlighting the need for alternative vascular access methods in infants and toddlers.
Area of Science:
- Emergency Medicine
- Pediatric Critical Care
- Vascular Access
Background:
- Establishing peripheral intravenous (PIV) access in children presents significant challenges, particularly in prehospital emergency settings.
- Timely vascular access is critical for managing emergent pediatric conditions like seizures, hypoglycemia, and cardiac arrest.
Purpose of the Study:
- To analyze prehospital pediatric peripheral intravenous (PIV) access attempts, success rates, and the influence of patient age.
- To evaluate the feasibility and effectiveness of PIV placement in emergent pediatric care outside the hospital.
Main Methods:
- Retrospective chart review of pediatric patients (≤18 years) with prehospital PIV attempts from January 2003 to May 2011.
- Data extracted from electronic patient care reports documenting PIV attempts and outcomes.
- Emergency medical service providers reported PIV success and failure rates.
Main Results:
- Out of 261,008 ambulance responses, PIV attempts were made in 4188 pediatric patients.
- Overall PIV success rate was 88.3% (3699/4188), with failure in 11.7% (489/4188).
- Age significantly correlated with success; each year increase raised odds of success by 11% (OR 1.11). Success was lowest (64.1%) in children under 2 years.
Conclusions:
- Prehospital PIV attempts are infrequent, occurring in approximately 2% of emergent pediatric responses.
- Pediatric PIV success rates are strongly age-dependent, with the lowest rates observed in patients aged two years and younger.
- Alternative vascular access strategies should be considered for very young pediatric patients in prehospital settings.
Objective:
Achieving successful peripheral intravenous (PIV) vascular access in children can be difficult. In the prehospital setting, opportunities are rare. Obtaining access becomes vital in emergent and life-threating conditions, such as seizures, hypoglycemia, and cardiac arrest. This study examines prehospital pediatric PIV attempts, success rates, and the impact of patient age.
Methods:
This was a retrospective chart review of patients aged 18 years or younger receiving prehospital PIV attempts from January 1, 2003, through May 31, 2011. Included cases were identified by querying electronic patient care reports for PIV attempts within the specified age range. The documentation of PIV attempts and successes was reported by emergency medical service providers. This study was approved by an institutional review board.
Results:
Throughout the 101-month study period, there were 261,008 ambulance responses. PIV attempts were made in 4188 patients aged 18 years or younger. PIV placement was successful in 3699 patients (88.3%) and failed in 489 (11.7%). Age was significantly associated with success. Each 1-year increase in age was associated with an 11% increase in odds of PIV success (odds ratio, 1.11; 95% CI, 1.09-1.12; p < 0.001). Success was lowest in patients younger than 2 years old, with an overall success rate of 64.1% (141/220). Accounting for multiple attempts, success was achieved in 53.0% of attempts (141/266).
Conclusions:
Prehospital PIV attempts are uncommon (2% of emergent responses). Success rates are significantly associated with patient age in the pediatric population and lowest in those aged 2 years or less. Consideration of alternative forms of vascular access in this population may be beneficial.
Related Concept Videos
01:27Parentral Nutrition: Centeral and Peripheral Parental Nutrition
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
01:25Hemodialysis I: Introduction