Mil Med. 2019 Mar 1;184(Suppl 1):329-334

# Reduced Complications of Supraclavicular Approach in Simulated Central Venous Access: Applicability to Military Medicine.

Sappenfield J, Grek S, Cooper L, Lizdas D, Lampotang S

In a study with 76 anesthesia providers on a mixed reality simulator, central venous access via the supraclavicular approach to the subclavian vein, without ultrasonography required less attempts compared to the infraclavicular approach. Participants had shorter times to venous access and larger improvements in confidence. Results from this simulation-based study indicate that the supraclavicular approach may deserve consideration as an alternative approach for central venous access in deployed military environments. The use of ultrasonography during the supraclavicular approach to the subclavian vein is also described which may improve its safety profile. This technique could be more appropriate in scenarios when central venous access is preferred over intraosseous access for patients being transported to another location for further care.