Picture this: You're administering general anesthesia to an obese 50-year-old patient undergoing abdominal laparoscopic surgery. As her blood pressure dips below 80 mmHg systolic, you promptly administer 100 mcg of phenylephrine. Despite this, her blood pressure continues to fall, reaching 75 mmHg, with a heart rate of 70 BPM. In response, you administer 10 mg of Ephedrine, but to no avail. After reducing the sevoflurane concentration and administering an additional 20 mg of Ephedrine IV, you reach underneath the drapes and realize the treatment isn't taking effect because the IV line has infiltrated, rendering your vasopressors ineffective as they're being injected subcutaneously. Now, you're faced with a hypotensive patient and a compromised IV line, recalling the initial difficulty in placing the IV in the forearm. In THIS video, we showcase how an IV catheter placed in the cephalic vein can bridge this acute situation until a more conventional IV catheter can be inserted with ultrasound guidance in the upper extremity or central venous access is established. This technique featured in the video underscores the importance of considering alternative IV access points, in emergency situations as a temporary solution that can buy crucial time for patient safety.

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