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Association of Anaesthetists guidelines: safe vascular access 2025

Johnston AJ, Simpson MJ, McCormack V, Barton A, Bennett J, Chalisey A, Crane J, Curry S et al.

Anaesthesia, 2025

21 citations

Abstract

Introduction: Safe vascular access is integral to anaesthetic and critical care practice. However, despite technological and procedural advances, it remains a frequent source of adverse events and patient harm. Ensuring a safe and effective approach to the selection, insertion and care of vascular access devices should be a priority for all practitioners.

Methods: This updated consensus statement builds upon previous iterations of safe vascular access guidelines. An expert, multidisciplinary, multi-society working party agreed on major themes and conducted a review of literature and best practice to build a comprehensive body of work. This was followed by a two-round Delphi process to agree on specific recommendations and to inform these concise guidelines.

Results: We agreed successfully 15 recommendations encompassing operational, training and clinical issues with an emphasis on a holistic approach to vascular access and long-term vessel health. These recommendations were divided into six major themes, covering: process (vascular access teams and responsiveness key performance indicators); device selection; insertion, including the use of safety standards, ultrasound, catheter tip position and vein/catheter ratios; the management of anticoagulation therapy, catheter-related thrombosis and coagulopathies; specific patient groups, including patients requiring renal replacement therapy, following mastectomy and axillary lymph node resection and the use of peripheral…

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