How to Insert IV Cannula in Neonate

Intravenous (IV) cannulation is a procedure commonly performed in neonates to administer medication, fluids, or parenteral nutrition. Proper insertion of an IV cannula is crucial to ensure the neonate’s safety and minimize complications. In this blog post, we will guide you step-by-step on how to insert an IV cannula in a neonate.

Step 1: Gather the necessary equipment

Before beginning the IV cannulation procedure, ensure that you have gathered all the required equipment. This includes:

  • A suitable-sized IV cannula (usually 24-26 gauge for neonates)
  • An appropriate IV infusion set
  • A sterile dressing pack
  • An antiseptic solution, such as chlorhexidine or povidone-iodine
  • Cotton balls or swabs
  • Gloves and a mask for personal protection

Step 2: Prepare the neonate and the environment

Before starting the procedure, ensure that the neonate is in a stable condition. Place the neonate on a clean, flat surface, and position a roll or towel under their arm to expose the vein. Also, make sure the environment is well-lit and free from distractions.

Step 3: Perform hand hygiene and wear personal protective equipment (PPE)

Prior to handling any equipment or touching the neonate, perform proper hand hygiene by washing your hands with soap and water for at least 20 seconds. Once your hands are clean, put on gloves and a mask to prevent the risk of infection.

Step 4: Choose an appropriate insertion site

In neonates, the most commonly used sites for IV cannulation are the dorsal hand veins, scalp veins, and foot veins. Evaluate the neonate’s veins and choose an appropriate site that is visible, palpable, and suitable for cannulation.

Step 5: Prepare the site and insert the cannula

Here’s how to insert the IV cannula:

  1. Cleanse the chosen site with an antiseptic solution using gentle swabbing motions.
  2. Allow the site to dry completely or use a sterile cotton ball to pat it dry.
  3. Hold the cannula at a shallow angle to the skin and advance it gently into the vein.
  4. Once blood flashback is observed in the cannula chamber, slightly lower the angle and advance it further.
  5. Secure the cannula in place with appropriate dressings.

Step 6: Post-insertion care

After inserting the IV cannula, implement proper post-insertion care. Secure the infusion set, ensure proper flow rate, and regularly monitor the insertion site for signs of complications, such as infection or phlebitis.

Tips for successful IV cannulation in neonates

  • Practice proper positioning and stabilization techniques to minimize movement during cannulation.
  • Use a transparent dressing to facilitate observation of the insertion site.
  • Seek assistance from experienced healthcare professionals for difficult cases or if you lack confidence.
  • Maintain a calm and soothing environment to reduce the neonate’s stress.


Inserting an IV cannula in a neonate requires precision and attention to detail. By following the step-by-step guide provided in this blog post and considering the tips for success, healthcare providers can ensure the safe and effective administration of medications and fluids in neonatal patients.

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