Venous Access

Overview :

For peripheral venipuncture the common site is usually a vein in the arm (the anticubital fossa located on the opposite side of the elbow) or on the flat bony area of the hand (dorsum of the hand). Scalp veins are accessible in infants under one year of age. The selected vein should be long and straight for needle accommodation. It should be identified by straightness, lack of pulsation (characteristic of an artery), and filling with blood from above (arteries fill from below). Internal jugular catheterization is performed in the neck using special bone and muscle landmarks. The external jugular vein can be cannulized by immobilizing tilted and rotating the head. The subclavian approach is a complicated procedure and emergency access can be performed if attempts for access a vein in other areas have failed. Intraosseous venous access is usually accomplished through a leg bone. Catheters implanted in the front of the chest (anterior chest wall) can accomplish long-term venous access. A large leg vein is preferably used and isolated by dissection. A catheter is inserted into the vein and they are tied together.