Introduction: For sick, hospitalized newborns, venous access is a prerequisite for safe and effective treatment. Possible venous accesses that can be established in a newborn are peripheral intravenous cannula and central venous catheter. Later can be inserted through the umbilical vein (umbilical catheter), into larger veins (femoral, jugular, subclavian) or into a peripheral vein. Purpose: To present the main characteristics, advantages of use and possible complications of individual venous access in newborns. To present the role of a registered nurse in the introduction, removal, and handling of each approach and to answer the question in which cases to use a peripheral and when a central venous approach. Methods: We used a descriptive method with a review of the literature. In the search, we used literature published from 2013 to 2023. We searched for literature in Slovenian and English using the keywords neonate, peripherally inserted venous line, peripherally inserted central catheter, central venous catheter, and umbilical catheter. We used PubMed and DiKUL search engines and examined CINAHL and CochraneLibrary databases. 21 articles were included in analysis. Results: The first choice of venous access in critically ill newborn is umbilical catheter, which can be used for up to one week. If the newborn is still unstable after removing umbilical catheter, next option is central venous catheter, but if the newborn is stable, we decide on the next intravenous approach based on the expected time of the need for infusion. When we anticipate that the need for infusion will be longer than seven days or we need to administer fluids incompatible with the peripheral route, we use PICC line, otherwise a peripheral venous cannula. Discussion and conclusion: Venous approaches differ from each other depending on the injection site, the end point of the tip, the material, the size, and the number of lumens of the catheter. As a result, they have different purposes, risks or complications and specifics in nursing. The role of the registered nurse is crucial in ensuring safe and effective use of venous access and care of the neonate with an indwelling venous catheter. Therefore, it is important that nurse knows specifics of possible venous approaches and indications for use. As an advocate of the best options for the patient, nurse can participate in the decision for right venous approach for sick newborn.
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