There are thousands of emergencies every year that require the resuscitation of infants and children. These emergencies can occur in almost any setting and providers need to be prepared to intervene. The goal in any resuscitation is to maintain adequate oxygenation and perfusion while interventions are taken to stabilize the child. Resuscitation should proceed in an orderly fashion beginning with the ABCs: airway, breathing, and circulation.

As part of the circulation sequence during advanced life support, it is necessary for the provider to establish venous access as a route to administer medications, fluids, and blood products, and to obtain blood for analysis. Nevertheless, even in the hands of experienced providers, obtaining IV access in pediatric patients can be difficult. The preferred site for access is the one that is readily accessible and will not interfere with the resuscitation. There are several peripheral sites that providers should familiarize themselves with where IV access can be obtained. Central venous access is another option in the event that the proper equipment and trained personnel are available. An attempt to establish peripheral and central venous access can be approached simultaneously.