Inpatient Clinical Pathway for Vascular Access

Patient Requiring IV Access in the Inpatient Setting

KOPH: Contact VAS Charge RN
Emergent IV Access
Urgent IV Access – Stable patient
Access required within 1 hour
  • Unstable Patient
  • Skilled unit-based resource with immediate call to VAS
  • IO consideration
  • CAT, Code or Tier activation to manage
  • Stable Patient
  • Peripheral IV Access
    • Notify VAS
    • 2 attempts by:
    • US guidance as clinically indicated
Non-difficult Venous Access
Difficult Venous Access
Unit-based resource,
if available 2 attempts
Failed
Notify VAS
Consider PIV, US guided as clinically indicated by trained provider
Failed
Failed
  • Immediate consideration of the following:
    • Continued PIV attempts including lower extremity, EJ
    • Alternatives to IV
    • IO placement
    • Consult IR Via Epic On-call Finder
  • If clinical deterioration imminent, move to Emergent Access for Unstable Patient
  • Consider the following:
  • If clinical deterioration imminent, move to Emergent Access for Unstable Patient
Vascular Access Obtained
PIV
Central Venous Access
  • Daily vascular access assessment on rounds
  • Guidelines for when to Consider Central Venous Access
  • IR consult as indicated
  • Daily vascular access assessment on rounds
  • IR consult as indicated
  • Consider antimicrobial lock if eligible
Posted: May 2017
Revised: July 2024
Editors: Clinical Pathways Team