[Venous access in emergencies].

Abstract

A reliable venous access is necessary for pharmacological treatment in case of emergency. The indication, pharmacology of the drug or the infusion and the expected period of intravascular penetration are decisive for choosing the location for the punction. As a principle all visible veins could be punctured and used for injection; all but varicose or thrombotic veins. Primarily the distal veins of the extremities should be punctured with a venous catheter and only in case of failing one should try more proximal. In case of accidently artery punction the cannula has to be left in place and a pharmacological therapy has to be started immediately. If a peripheral venous punction is impossible the central venous catheter is an alternative even of its remarkable higher rate of complications. Three ways of access to the central veins can bei recommended: the jugular interna vein, the subclavian vein and the basilic vein. Advantages as well as disadvantages are elaborated. As a result the physician in cases of emergency should use the technique of venous punction he is used too in a routine situation.