Exploring Axillary Vein Central Cannulation in Critically Ill Trauma Patients: A Focus on Infraclavicular Techniques

Abstract

Managing major trauma in hospital settings, especially in emergency departments, presents significant challenges. Hypovolemic shock, often resulting from hemorrhage, is commonly due to bleeding in non-compressible areas like the abdomen and thoracic cavities, complicating intravenous access. Central vein cannulation is typically performed for effective volume resuscitation and blood transfusions prior to surgery, with common sites including the internal jugular, subclavian, and femoral vessels. However, in acutely bleeding trauma patients, early pre-hospital interventions such as cervical collars and pelvic binders can impede the cannulation of these veins and limit access to traditional central venous sites. This article explores the cannulation of central axillary veins, an underutilized yet advantageous route. Central axillary veins are readily accessible and provide a viable alternative for resuscitation in major trauma patients in emergency settings, offering a practical solution when other central venous access points are compromised.