Continuing Education Activity
The establishment of venous access is essential to the treatment and resuscitation of both the medically and traumatically ill patient. Adequate venous access allows the delivery of fluids, blood products, medications, and repeated blood sampling. The venous cutdown technique is a surgical procedure designed to gain venous access when relatively less invasive percutaneous procedures such as the Seldinger technique (percutaneous access), ultrasound-guided venous access, and intraosseous vascular access have failed. Percutaneous access can be difficult to achieve in certain patient populations (pediatric patients with small and nonpalpable veins, patients in hypovolemic shock with collapsed veins, patients with peripheral vascular disease with altered vascular anatomy) making venous cutdown a useful alternative in an acute setting. This activity reviews the relevant anatomy, technique, and potential complications of saphenous vein cutdown and highlights the role of the interprofessional team in managing patients with limited intravenous access.
Objectives:
- Identify the anatomy of the saphenous vein.
- Describe the equipment needed for a saphenous vein cutdown.
- Review the complications of saphenous vein cutdown.
- Describe how interprofessional teams can improve care coordination to advance intravenous access in patients with shock and improve patient outcomes.