What is the recommended action if IV access is not achieved promptly during pediatric arrest?

• A. Continue attempting IV access.
• B. Establish intraosseous access promptly.
• C. Abort resuscitation.
• D. Wait for IV access to become available.

Answer: (B)

Getting rapid vascular access is essential in pediatric arrest to deliver medications and fluids during CPR. When IV access cannot be obtained promptly, establishing intraosseous access is the best next step because it provides a fast, reliable route directly into the central circulation. IO access can be obtained quickly in children, often with a high first-attempt success rate, and allows you to administer all resuscitation drugs and fluids without delaying chest compressions. This approach minimizes interruptions in CPR and speeds up drug delivery, which is crucial for improving outcomes. Once IO access is secured, continue with the resuscitation protocol and administer medications through the IO route as indicated. Abort resuscitation or delay for IV access is not appropriate when IV cannot be obtained promptly.