ED Pathway for Evaluation/Treatment of Infants > 28 Days of Age and Children with Severe Sepsis

IV Access and Escalation


Minutes Access Procedure
0-5 First peripheral IV with largest gauge possible
Consider IO immediately in severely ill patients
5-10 2nd peripheral attempt
  • Consider US guided peripheral IV
  • Consider EJ (US guided)
  • Notify vascular access specialist (IV team)

If still no access

  • EZ-IO
  • EJ (consider US guided)
  • Central line (consider US guided) or
  • Call PICU to assist at bedside
  • Consider Chief Surgical Fellow as additional resource