Provision of venous access

Access to the venous bed is possible in three ways: Venous accesses are used for the application of intravenous infusions ( indications : administration of substitute solutions in case of blood loss, during anesthesia, long-term administration of antibiotics, parenteral nutrition... ) or of blood transfusions , or for monitoring hemodynamics (measurement of central venous pressure…).
 * 1) Venepuncture – stabbing a vein and inserting a cannula or catheter:
 * 2) peripheral veins – in the elbow socket (v. basilica, v. cephalica), on the forearm and the back of the hand;
 * 3) central veins – subclavian vein, external or internal jugular vein, rarely femoral vein (central venous catheter = catheter, the end of which lies in the vena cava).
 * 4) Venesection – surgical exposure of the vein, its opening and insertion of the cannula (if it is not possible to perform a venipuncture, e.g. if the veins are collapsed due to heavy blood loss) – v. basilica, v. cephalica,, v. jugularis externa, v. saphena magna.
 * 5) Intraosseous venous access – if the attempt to cannulate the vein is unsuccessful, a special threaded needle is inserted into the marrow of the long bones (tibia under the tuberositas tibiae, distal part of the femuru, above the inner ankle, into the spina iliaca)

When deciding on venipuncture or venesection, we prefer the HK or the neck (there is a risk of phlebothrombosis in DK ) and we perform it as peripherally as possible (so that the same vein can be punctured multiple times) and if possible not above the joint (so that the patient is not limited in movement).

Techniques of puncture approaches

 * 1) Catheter through the needle;
 * 2) catheter through the needle
 * 3) catheter through the cannula;
 * 4) along a wire conductor ( Seldinger technique).

Complications of venous access

 * 1) Vein puncture;
 * 2) paravenous application of the drug;
 * 3) air embolism;
 * 4) inflammation and thrombosis at the injection site;
 * 5) pneumothorax, hemothorax;
 * 6) for long-term inserted catheters: thrombosis, infection or catheter sepsis.

Due mainly to infectious complications, it is necessary to remove every catheter that will not be used any further, where complications have occurred (swelling, redness, pain, ...) and also replace within 48 hours a catheter that was inserted under non-standard conditions (for example, RZP).

Peripheral vein securing procedure
We perform on an accessible peripheral vein. Most often in the basilic vein, cephalic vein, veins on the forearm, back of the hand. In exceptional cases, the veins of the lower limbs or the neck can also be used. We proceed similarly to taking venous blood. We always work with gloves.


 * 1) Applying a tourniquet;
 * 2) finding a suitable vein;
 * 3) careful disinfection of the injection site;
 * 4) inserting a cannula into a vein;
 * 5) releasing the tourniquet;
 * 6) securing the cannula against movement;
 * 7) removing the needle and leaving the plastic catheter;
 * 8) connection to the appropriate infusion.

related articles

 * Providing Peripheral Venous Access - Detailed
 * Central venous catheter
 * Central vein cannulation (pediatrics)
 * Arterial Catheter
 * Arterial cannulation - detailed
 * Swan-Ganz Catheter Insertion (Paediatrics)
 * Intraosseous infusion
 * Seldinger Technique