Association of Anaesthetists guidelines: safe vascular access 2025.

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 vasoconstrictors; and training in advanced vascular access. DISCUSSION It is hoped that these guidelines, together with the larger body of work, will improve the care of patients who require vascular access, embed a more holistic approach to vascular access and lifetime vein preservation, and support staff and hospitals with vascular access service development.