ABSTRACT
This chapter reviews some theoretical ‘worst-case’ venous access complications. It focuses on such challenging and difficult examples specifically because they illustrate the major principles that underpin both how to handle and also avoid such major complications. The chances of successful occlusion of the brachial artery puncture site are improved by pressing directly down over the puncture site, with the artery being compressed against the underlying humerus bone. It is also helpful to have the patient's arm resting on a firmer surface. Once a femoral line has served its purpose, remove it as soon as possible and consider other access options if available. Line care and maintenance is vitally important. If this line had been inspected and signs of infection identified earlier, the deterioration to septic shock might have been avoided.
