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Personally, my rule is 2 attempts if the IV fits in the category of "nice to have" or I'm in a student role. If the IV is in the "MUST HAVE" then I'll stick as many times as necessary, using whatever route is available to obtain patent vascular access. I'll do 3 peripheral attempts and then consider IO next. While it's nice to see the veins (normal or enhanced ways), I much prefer to feel them to get a better sense of them.