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Rapid venous access using saphenous vein cutdown at the ankle
K J Rhee1, R W Derlet, S L Beal
1Department of Internal Medicine, University of California-Davis.
The American Journal of Emergency Medicine
|May 1, 1989
Summary
Venous cutdown is a reliable emergency procedure for adult patients needing rapid venous access when other methods fail. This study found an 84.9% success rate with minimal complications, making it a valuable technique.
Area of Science:
- Emergency Medicine
- Vascular Access Techniques
Background:
- Peripheral intravenous lines are standard for adult injuries.
- Hypotensive patients may require alternative venous access methods like venous cutdown.
- Limited data exists on the efficacy of venous cutdown in emergent adult situations.
Purpose of the Study:
- To evaluate the success rate and time required for venous cutdown in emergent adult cases.
- To compare the success rates among different operator experience levels.
Main Methods:
- A retrospective review of 73 venous cutdown attempts on 56 adult patients over one year.
- Data collected included success of venous cannulation, time to placement, and complications.
Main Results:
- A 84.9% success rate for venous cannulation was achieved.
- The average time for venous cutdown placement was 4.9 minutes.
- First-year residents had a lower success rate (70%) compared to experienced staff (89%-94%).
Conclusions:
- Saphenous vein cutdown at the ankle is a reliable method for rapid venous access in adults.
- The procedure has a high success rate and few complications when performed by experienced operators.
- Complications are minimal if the catheter is removed within 24 hours.