title: Critical skills and procedures in emergency medicine: vascular access skills and procedures.
abstract: The venous and/or arterial vasculature may be accessed for fluid resuscitation, testing and monitoring, administration of blood product or medication, or procedural reasons, such as the implantation of cardiac pacemaker wires. Accessing the vascular system is a common and often critically important step in emergency patient care. This article reviews methods for peripheral, central venous, and arterial access and discusses adjunct skills for vascular access such as the use of ultrasound guidance, and other forms of vascular access such as intraosseus and umbilical cannulation, and peripheral venous cut-down. Mastery of these skills is critical for the emergency medicine provider.
authors.affiliation: Department of Emergency Medicine, University of North Carolina, 170 Manning Drive, CB # 7594, Chapel Hill, NC 27599-7594, USA.
authors.forename: Gemma C
authors.initials: GC
authors.lastname: Lewis
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Crapo
authors.forename: Jefferson G
authors.initials: JG
authors.lastname: Williams
mesh_terms: D002404:Catheterization / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D002408:Catheters, Indwelling / Q000009:adverse effects; D004630:Emergencies; D006801:Humans; D017148:Infusions, Intraosseous / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D018084:Ultrasonography, Interventional / Q000295:instrumentation / Q000379:methods; D014469:Umbilical Arteries; D016748:Venous Cutdown / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods