Modern Approach to Vascular Access in the Critically Ill Patient.

Vascular access is a key intervention in the management of critically ill emergency department patients. This can include peripheral or central venous access and intraosseous access. In combination with arterial catheterization, central venous access can provide key information to guide volume and vasoactive medication titration in isolation as well as in combination with dynamic measures of fluid responsiveness. This article will review the indications and contraindications as well as decision-making for the use of these modalities in light of the current evidence.