For a 2-year-old child with dehydration, which IV insertion site is most appropriate?

The most appropriate IV insertion site for a 2-year-old child with dehydration is the venous arch on the top of the foot. This site is generally considered favorable for several reasons.

In young children, including toddlers, distal sites like the venous arch on the top of the foot are often preferred due to their accessibility and the relative ease of cannulation. This area usually has adequate blood flow, and the veins are more superficial and easier to locate compared to deeper veins, making it less traumatic for the child during insertion.

Additionally, using the hand or forearm, such as the dorsal metacarpals or the basilic vein at the antecubital fossa, might not be ideal in younger children because the veins can be smaller and more challenging to access. The scalp vein near the fontanel, although available, is typically reserved for situations where other sites are not accessible or in neonates. The foot's venous arch finds a great balance between accessibility and usability, making it a common first choice for pediatric IV access, especially when dealing with a child experiencing dehydration.