Comment by bearsnowstorm

For really small kids we tend to use a transilluminator rather than ultrasound for peripheral IVs (though it doesn’t tell you the depth like ultrasound does). For CVCs or bigger people, ultrasound is often very useful. Like all things, experience makes a big difference! In my opinion, for known tricky veins (in adults at least) it’s best to use local anaesthetic from the outset - it does make it slightly harder but if (when?) you miss it’s easier to keep the patient on side for the next attempt.

Edit: YouTube link to a transilluminator being used - beware the video does have an unhappy child in it

https://youtu.be/ixyqKa3bDMQ