Author: Dave McCreary

A 65-year-old female undergoing chemotherapy for breast cancer presents to your ED with septic shock and likely febrile neutropenia. She does not have any central access device and tells you that the nurses and doctors always struggle finding her veins. You put the tourniquet on and cannot palpate a vein or visualise one on the back of her hands. Do you try to find a vein blindly, potentially wasting precious minutes and increasing time to antibiotics and fluids/inotropes with multiple attempts, or do you reach for the ultrasound probe?