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Vascular Access on the 21st Century Military Battlefield
  1. Surg Lt Cdr Elspeth J Hulse, MBChB FRCA, Specialty Registrar1 and
  2. GOR Thomas, Honorary Consultant Anaesthetist2
  1. 1Royal Cornwall Hospital, Truro, Cornwall
  2. 2The Royal London, and Queen Victoria’s Hospital, East Grinstead, London & 16 Air Assualt Medical Regiment
  1. Anaesthetics Department, Derriford Hospital, Plymouth PL6 8DH 0845 155 8155 elspeth_uk{at}hotmail.com

Abstract

Timely and appropriate access to the vascular circulation is critical in the management of 21st century battlefield trauma. It allows the administration of emergency drugs, analgesics and rapid replacement of blood volume. Methods used to gain access can include; the cannulation of peripheral and central veins, venous cut-down and intraosseus devices. This article reviews the current literature on the benefits and complications of each vascular access method. We conclude that intraosseus devices are best for quick access to the circulation, with central venous access via the subclavian route for large volume resuscitation and low complication rates. Military clinicians involved with the care of trauma patients either in Role 2 and 3 or as part of the Medical Emergency Response Team (MERT), must have the skill set to use these vascular access techniques by incorporating them into their core medical training.

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