Obtaining intravenous (IV) access is a basic necessity in the emergency department. So what do you do when you are unable to place a peripheral IV, and your go-to external jugular line is not an option? You certainly do not want to place an IO in a stable patient, and you definitely want to avoid placing a time-consuming and potentially dangerous central line. Ultrasound guided peripheral IVs are quickly becoming the standard of care for patients with difficult IV access. This article will review the skills needed for successful placement.

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