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significantly reduced their use of this tool. After explaining the procedure to the
family, open the papoose across the ED stretcher. Place the child supine on the
papoose, and expose the body area necessary for treatment. Beginning with the
midabdominal restraints, cover the child across the midline with the Velcro-lined
flaps ( Fig. 130.1C ). Better exposure of the extremities, such as the hand, is
obtained by flexion of the area under the harness ( Fig. 130.1D ). Before starting
a wound repair or other procedure, reassess for the safety and adequacy of
immobilization of the child and correct it if necessary. Again, leaving an
arm/hand free for a parent or staff member to hold can aid in both comfort and
distraction.
There is a small group of children with autism spectrum disorders (ASDs) that
may find the papoose calming due to the containment and pressure. The papoose
may be offered to families with children with an ASD as a first line of restraint as
opposed to manual restraint by staff.

EXTERNAL JUGULAR VENIPUNCTURE OR PERIPHERAL
CANNULATION
Indications
Venous blood sampling or placement of a peripheral intravenous catheter when
peripheral veins on the extremities are inadequate.

Complications
1. Hematoma
2. Infection

Equipment
Venous blood sampling: Butterfly (21 to 23 gauge); 5- to 10-mL syringe;
povidone-iodine or chlorhexidine antiseptic solution; sterile gauze.