POCUS guided small saphenous vein cannulation: A novel approach for peripheral venous assess in prone position

Peripheral intravenous cannulation (PIVC) is a routine procedure in perioperative, and critical care settings and nearly one-third of the patients may have difficult intravenous access (DIVA). PIVC is challenging in a prone position in an intraoperative setting when there is a need for emergency access. Point of care ultrasonography (POCUS) is becoming the standard for assisting DIVA and improving the success rate. The small saphenous vein (SSV) in the posterolateral side of the mid-calf is a consistent vein in the lower extremity that provides an acceptable diameter and optimal depth for POCUS-guided PIVC in the prone position. A successful SSV cannulation was performed with an 18-G peripheral intravenous catheter under POCUS guidance on a 34-year-old male polytrauma patient in the prone position during the intraoperative period scheduled for D2 spine fixation. The SSV can be a credible option for emergency DIVA in the prone position under POCUS guidance.