Establishing intravenous access in an emergency situation.

METHOD The authors use a simple technique which involves applying a tourniquet above the elbow and establishing intravenous access in the dorsum of the hand with a blue (22G) venflon. The tourniquet is left on and immediately 100 ml of normal saline is infused by compressing the fluid bag. This allows for the larger proximal veins in the cubital fossa to engorge enabling a 14G/16G venflon to be passed for rapid fluid infusion. Over a 9-month period from February 2012 to October 2012, we have employed this technique in all peripherally shut down patients referred to our care as the on-call general surgical registrar and senior house officer at Warrington and Halton Hospitals NHS Trust.