THE PAPER by Asnes and Arendar, appearing elsewhere in this issue of Pediatrics, is a reminder that even one of the simplest and most frequently performed procedures of pediatric practice in the hospital may be a source of serious iatrogenic disease.
Unfortunately, no statistical data are available for an analysis of the relative safety of the various methods of venipuncture; complications are infrequent with any of them if the operator is careful, skilled, and familiar with the method he is using. On the other hand, since accidents on complications may also result from any method used, it is self-evident that those procedures in which the complications are relatively minor are preferable to those in which the complications threaten life or may result in permanent handicap. A specific method may carry an unacceptable risk for a particular patient, yet be the method of choice for most others. Under any circumstances the hazard of the procedure, be it great or small, must be weighed against what is to be gained from it, so that good judgment in its use is always an important factor in the safety on hazard of even so simple a procedure as venipuncture.
Although there are at least 14 possible sites from which to obtain venous blood from infants and children, only three (antecubital, external jugular, and femoral veins) are currently widely used in the United States. The internal jugular vein and superior sagittal sinus have been almost universally discontinued as routine sites because of the potentially fatal nature of complications when they occur.