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Tuesday, May 11, 2021

Difficult Vascular Access

emDOCs Podcast Episode 28 - May 11, 2021 - By Brit Long
“Key Points
  1. When a patient is in extremis and PIVs are not easily obtainable, don’t hesitate to place an IO
  2. Utilize a pressure bag with any form of intravascular access to increase flow rates
  3. Blood aspirated from an IO can be used for laboratory analysis, although not all values will be accurate
  4. If using the landmark-approach, use adjunctive techniques to increase rates of success
  5. Consider the external jugular vein before jumping to ultrasound-guided PIV
  6. When placing an ultrasound guided IV, vessels that are more superficial and wider in diameter will lead to increased successful placement
  7. Longer catheters with the majority of the catheter in the vessel lead to increased lifespan of ultrasound-guided IVs
  8. If ultrasound-guided peripheral IV placement isn’t successful, consider an “easy-IJ” before placing a CVC
  9. Midline catheter placement is an emerging alternative to both ultrasound-guided IVs and CVCs”