Vascular access is critical in managing the perioperative patient. In critical
situations, establishing adequate vascular access is often difficult, invasive, and carries
significant risks. Ultrasound is an invaluable tool in facilitating efficient and safe
vascular access. Ultrasound helps to verify the presence, position and potency of the
target vessel prior to the needle puncture and provides real time imaging of the needle
throughout the vasculature (puncture process. The following chapter reviews the basics
of ultrasound physics and machine knobology for optimizing image acquisition. The
specifications of establishing central access – internal jugular vein, subclavian vein,
axillary vein, and femoral vein; as well as obtaining arterial access are discussed in
detail. Sources that are useful to continue one’s education are also included.
Keywords: Acoustic impedence, Arterial access, Axillary vein, Doppler effect,
Femoral vein, Refraction, Scattering, Spatial resolution, Subclavian vein,
Ultrasound, Ultrasound for difficult intravenous access, Ultrasound for internal
jugular vein.
