Intravenous access in the emergency patient

SummaryObtaining intravenous access in the emergency department can be extremely difficult, time consuming and sometimes even impossible. Time and patient safety is of the essence. This article outlines different techniques for gaining peripheral, central and intraosseus access. We go through some of the vast amount of evidence supporting the use of real-time ultrasonography and describe its use and common pitfalls. Ultrasound equipment is readily available in almost every hospital but is often not used. Our hope is that this article can give physicians and nurses some means to increase their success rates and decrease the amount of time they spend on gaining intravenous access. Hopefully patient satisfaction will increase at the same time.