Emergency situations demand swift action; obtaining IV access can be the difference between life and death. However, the process is fraught with difficulty, especially in patients with compromised vascular access due to dehydration, trauma, shock, obesity, or IV drug use. We introduce a practical algorithm specifically designed for IV access in emergency settings to streamline the decision-making process and enhance clinical outcomes. These algorithms are step-by-step guides that address initial site selection, techniques for difficult IV access, use of ultrasound-guided venipuncture, and alternative access methods such as IO infusion. It is intended to serve as a practical tool for clinicians, reducing the time to achieve access and improving patient care.

These algorithms emphasize a systematic approach, starting with the least invasive methods and progressing to more advanced techniques if initial attempts fail. They consider patient-specific factors and encourage clinicians to use clinical judgment and patient assessment to guide their choice of technique.