 - The patient will be enrolled as a subject and the data collection form will be filled out by a trained observer. The data collection form contains: trained observer level of training; blinded nursing number; randomization number; patient gender, age in months, weight, height, Fitzpatrick skin color, dehydration status, mental status, gestational age, chronic medical conditions, and hospitalizations in last two years; nurses assessment of vein palpability, visibility, and subjective difficulty; nurses pediatric ED experience and overall experience in years; access tool and whether crossover was utilized; IV gauge, IV access site, number of persons needed to assist, and whether access was successful. All trained observers will have undergone training to ensure reliability between observers. Once a patient has been identified as a potential subject by the trained observer and consent has been obtained, a blinded randomized manila envelope will be chosen. The data collection form will be completed by the trained observer and then the nurse will attempt first IV attempt per the arm of the study standard versus with AV400 assistance. The patient will receive two attempts using the assigned randomized method. If 2 failed attempts, the nurse will cross arms of the study and use the other IV access method. If this fails, the standard difficult IV access pathway used by the pediatric ED will be started. Currently this pathway is started after 4 failed IV attempts. Therefore, there is no additional risk to the subject in the study. After the IV access has been successful or the difficult IV access pathway has begun, the trained observer will then ask the parent and nurse a series of questions based on a Likert scale to assess satisfaction and whether the nurse felt the AV400 helped find veins, distracted herhim from usual technique, andor saved time. No identifying data will be collected on the nurse or subject. Trained observers will not be ordering any IV placements, labs or medications for subjects. Potential subjects will have had orders placed for IV access prior to their selection for eligibility. 