• Access for IV infusion and medications

• Sore or broken skin

• Cleaning solution (see local Trust policy)
• Appropriate blood bottles and request cards
• Non-sterile disposable gloves 
• 24 G cannula
• T-piece connected to a syringe of sodium chloride 0.9%, flushed and ready 
• Tape and splint to secure cannula 
• 3-way tap if necessary

• Identify suitable site:
  
  • preferably back of hand or foot
  • save long saphenous and antecubital fossa veins for long line insertion
  • scalp: shave area if using scalp vein (do not use as first priority site)
• Inform parents before procedure if possible
• Identify suitable vein, which should be clearly visible. Unlike in adults, neonatal veins are rarely palpable

• It can be helpful to flush cannula with sodium chloride 0.9% to assist in identification of point at which cannula enters vein. If blood samples taken at time of cannula insertion, do not flush cannula as this will contaminate sample for analysis
• Wash hands and put on gloves

Insertion

• Apply hand pressure around limb to distend vein
• Place thumb on skin slightly distal to proposed puncture site
• Hold cannula at 10–20° angle and puncture skin
• Advance cannula toward vein
  
  • resistance may diminish slightly as it enters vein and a speck of blood may be seen in hub of needle (this is easier to see if cannula has been flushed with sodium chloride 0.9%). Do not advance needle further as it can pierce back wall of vein
• When this occurs, hold needle steady and advance cannula a short distance within vein
• Withdraw needle from cannula
• Connect T-piece and flush cannula gently with sodium chloride 0.9% 0.5 mL to confirm it is in the vein
• Secure cannula with clear dressing (e.g. Tegaderm™/Opsite) to ensure IV site visible at all times, and connect to infusion 

Documentation

• Record date, time and site of cannula insertion in notes with identification and signature of person carrying out procedure (use local sticker if available)
• Record date and time of removal of cannula
• Use visual phlebitis scoring for ongoing monitoring of cannula, according to local Trust policy