The technical aspects of starting intravenous infusions have been abundantly discussed in the literature. While in the great majority of cases intravenous medication can be started with little difficulty and time loss, a substantial number remains where the patient's condition, the requirements of surgery, or other limiting factors make this procedure time-consuming and sometimes it is impossible to start a completely satisfactory intravenous drip. In the operating room a cutdown can be performed on these patients. This requires additional time, and its application is further restricted by the limited number of suitable veins. Consequently, anesthetic techniques may be modified to eliminate intravenous medication, and occasionally unnecessary risks are taken by administering anesthesia for major surgery without having a vein cannulated.
The difficulties in starting infusions are multiplied in pediatrics to the point where technical considerations may unduly influence the decision to administer parenteral fluids. The same is true in traumatic