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The pain and anxiety in the pediatric patient associated with vascular access is often a difficult matter to address in the prehospital setting. The need for rapid vascular access in a critically ill child along varying transport times does not typically allow for some of the pharmacological options for relieving the pain of IV insertion that are available in the ED and hospital setting. Various commercially available creams, gels, and patches often require several minutes up to an hour of application time to be effective. Local infiltration of lidocaine with either a small‐gauge needle or needle‐free system such as the J‐Tip has quicker anesthetic delivery but requires a second, often psychologically traumatizing, needle puncture or startling noise caused by pressurized CO₂. If the child is stable enough to consider the use of these pain‐reducing interventions, vascular access may potentially be deferred to arrival to the hospital. Medical oversight and training for pediatric patient care should focus on helping the EMS clinician distinguish the stable patient from the critically ill one who would benefit from early vascular access [28]. Additionally, for many EMS clinicians IV attempts for young children are infrequent and often difficult. Training may be needed to improve technical skills and confidence to increase success [29].