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Vascular Access Clinical Pathway – Inpatient

Clinical Pathway for Vascular Access Inpatient Non-ICU Setting

Child Requiring IV Access in the Inpatient Setting

Review history of difficult access, available in FYI banner
 
 
 
 
Peripheral Access
 
 
 
 
Non-Urgent
Urgent/Emergent
 
 
 
 
 
 
Non-Difficult Vascular Access or Unknown
Known Difficult Access
  • Initial attempt by clinician skilled in PIV placement if available
  • Immediate call to unit-based resource or VAS
  • US-guided PIV recommended for known difficult access
 
 
 
 
2 attempts by clinician skilled in PIV placement
US-guided PIV if trained provider available
 
 
Failed or unavailable
Failed or unavailable
 
 
Failed
 
 
  • Consult IR, ICU
  • Consider alternatives to IV (IM, IO)
  • Notify attending physician
  • Unstable or impending instability
    • Critical assessment team
 
 
Vascular Access Service (VAS) or unit-based resource atttempt
 
 
Failed
Team Huddle (Tier 0)
  • VAS, bedside RN and hospital provider
    • Fellow and attending if applicable, notify if not available
  • Document Tier 0 note as appropriate
  • Consider
    • Additional PIV attempts to lower extremities, EJ
    • Alternatives to IV (PO, NG, IM)
  • Consult IR
  • Review considerations for central venous access
 
 
Vascular Access Obtained
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