critical care medicine
Vascular Access
Peripheral Vein Catheterization
Most patients’ needs for IV fluid and drugs can be met with a percutaneous peripheral venous catheter. If blind percutaneous placement is difficult, ultrasonographic guidance usually results in successful placement. Venous cutdown can be used on the rare occasions when percutaneous catheter insertion is not feasible. Typical cutdown sites are the cephalic vein in the arm and the saphenous vein at the ankle. However, venous cutdown is rarely needed because of the popularity of peripherally inserted central catheter (PICC) lines and Intraosseous Infusion in both adults and children. For a step-by-step description of how to do peripheral vein catheterization, see How To Do Peripheral Vein Cannulation and Common complications (eg, local infection, venous thrombosis, thrombophlebitis, interstitial fluid extravasation) can be reduced by using a meticulous sterile technique during insertion and by replacing or removing the catheters within 72 hours. 