The size of a newborn IV cannula is either 24-gauge (yellow) or 26-gauge (purple/violet).
The 24-gauge (yellow) IV cannula is used most often for newborns, infants and small children that have delicate veins.
And the 26-guage (purple) size IV cannula is the smallest peripheral IV size and is used almost exclusively for premature infants or neonates with extremely tiny or fragile veins.
The high gauge numbers on IV cannulas mean a smaller outer diameter.
A 24-gauge IV cannula has an outer diameter of around 0.6 to 0.7 mm, while a 26-gauge is around 0.5 to 0.6 mm.
Doctors and clinicians choose the size of IV cannula based on the visibility of the vein, birth weight, and the type of fluids or medications that are needed.
When inserting an IV into a newborn or infant, doctors use small, short gauges often (24G or 26G) to minimize vascular trauma.
The safest site for IV in newborns and infants is the dorsal veins of the hand and the great saphenous vein in the foot, which are the most preferred peripheral IV sites for infants and are often considered the safest.
The back of the newborn or infants hand provides superficial, visible veins, which are easy to transilluminate and splint and are known as the (Dorsal Venous Network).
The great saphenous vein that is near the infants ankle or dorsal arch on the infants food is a favorite site for IV in infants because infants move their feet less disruptively than they do their hands, which makes stabilization easier.
And the scalp is often frequently used in newborns or when other peripheral sites fail because the infants scalp has rich blood flow, although this also requires careful prevention of air embolism.
And the inside of the infants elbow also known as the antecubital fossa is a great option for IV in infants when a large, stable vein is found, although it also requires an arm board to prevent bending.
When inserting an IV into an infant, doctors use small, short gauges often (24G or 26G) to minimize vascular trauma.
For immobilization doctors will often secure the limb properly with a splint or board, as infant movement is the leading cause of IV dislodgement or infiltration.
And doctors also assess the infants IV site hourly for any signs of swelling, leakage or infiltration.
When starting an IV on a newborn doctors choose the site based on how long the newborn needs treatment and how sick they are.
However IVs are started on newborns in the peripheral veins in the hands, feet and scalp as well as central lines via the umbilical cord.
The common peripheral sites where you start IV on newborns include:
The hands, which include the dorsal venous network on the back of the newborns hand.
The feet, which includes the saphenous veins or the dorsal arch on top of the newborns foot.
The scalp, which includes the superficial temporal, frontal, or auricular veins, which are also often prominent and visible in neonates.
And the arms, which include the Antecybital fossa or the inner elbow veins, although flexion areas are also prone to dislodging.
The special and central sites for starting an IV on newborns include:
An umbilical venous catheter or (UVC), which uses the vein in the umbilical cord stump for rapid or ey delivery room access and long term fluids.
PICC lines, which are peripherally inserted central catheters that are threaded through the arm, leg or scalp veins for long term nutrition.
And intraosseous (IO), which involves emergency bone marrow access in the tibia or femur if the veins of the newborn fail.
For peripheral intravenous (IV) access in infants, the dorsum of the hand and the great saphenous vein at the ankle/foot are considered the safest and most standard primary sites.
Distal veins are preferred first to preserve vein health, and selection depends heavily on the infant's mobility level.
Safety and Placement Considerations for IVs in newborns include:
Catheter size: A small, short 24-gauge or 26-gauge catheter is standard to minimize vessel trauma.
Joint avoidance: Avoid areas of flexion (like the wrist or antecubital fossa) whenever possible to prevent the line from kinking or dislodging.
Immobilization: Careful splinting of the limb is vital because infant movement easily dislodges peripheral lines.
Monitoring: Frequent hourly checks are required to catch fluid leakage into surrounding tissue (infiltration) early.