ICU Pathway for the Evaluation/Treatment of Infants > 28 Days and Children with Severe Sepsis/Septic Shock

IV Access and Escalation

Goal

Minutes Access Procedure
0-5 First peripheral IV with largest gauge possible
Consider IO immediately in severely ill patients
5-10 2nd peripheral IV attempt
  • Consider US guided peripheral IV
  • Consider EJ
  • Notify vascular access specialist (IV team)
10-15 If still no access (or insufficient access)
  • IO
  • EJ
  • Central line (IJ preferred for ScvO2 and CVP monitoring)
  • Consider IR or general surgical fellow as additional resource