Alternative Methods to Vascular Access in the Emergency Department
Originally approved by the ACEP Board of Directors June 2011
There are situations in the emergency department (ED) when standard intravenous access (IV) procedures fail or are insufficient to meet the clinical needs of the patient. Alternative access methods must be available under such circumstances and their usage should be a part of the standard emergency medicine practice privileges. These alternate access modalities include, but are not limited to, intraosseous lines, external jugular lines, and illumination device guided placement of peripheral lines. Policies and procedures for non-physician practitioners performing these procedures should allow for expeditious establishment of IV access via alternate routes when indicated. These policies should include a discussion of the initial and recurrent training requirements and provisions for periodic physician oversight, such as orders and/or protocols.