Procedure The infant younger than year of age has several easily accessible scalp veins These include the frontal, supraorbital, posterior facial, superficial temporal, and posterior auricular veins and their tributaries Restrain the patient in a supine position and have an assistant stabilize the infant’s head After assessment for the most accessible veins, shave an area large enough to expose not only the desired veins, but also an area of surrounding scalp for adequate taping of the infusion needle or catheter In this area, select a vein with a straight segment that is as long as the part of the needle or catheter that is to be inserted Verify the chosen vessel is a vein by palpating it to ensure it does not pulsate Place a rubber band around the infant’s head after attaching a small piece of tape to the rubber band to make it easier to lift and cut the rubber band after successful venipuncture Prepare the skin by cleansing with antiseptic solution and allowing it to dry Grasp a butterfly scalp vein needle by the plastic tabs or “wings” or the over-theneedle catheter at the base Keep the needle and syringe unattached initially to facilitate evaluation of free blood return Insert the needle in the direction of blood flow and pierce the skin approximately 0.5 cm proximal to the actual site where entry into the vein is anticipated ( Fig 130.7 ) While applying mild traction on the skin of the scalp, slowly advance the needle through the skin toward the vein Blood will enter the clear plastic tubing of the butterfly or the plastic tubing of the catheter with entry into the lumen of the vein Carefully cut the rubber band tourniquet, attach the syringe filled with saline flush solution, and slowly inject 0.5 mL of flush If the needle is satisfactorily inserted into the lumen of the vein, the solution will flow easily For catheterization, thread the catheter over the needle further into the vein continuing to assess for flow Appearance of a skin wheal when flushing the catheter indicates that the vein has not been satisfactorily cannulated, and another attempt must be made After successful catheterization, carefully tape the scalp vein needle or catheter as shown in the diagram To prevent accidental removal or infiltration of the vein, look for ways to position the infant safely UMBILICAL ARTERY CATHETERIZATION Indications Respiratory failure or cardiovascular collapse in the newborn infant for whom percutaneous attempts for vascular access have failed Used for resuscitation,