Сharacteristics of prehospital venous access in modern armed conflict

Background. Administration of blood products components therapy can significantly affect the outcome of hemorrhagic shock. In modern emergency medicine, the question of the need transfusion already at the prehospital stage is increasingly being raised. However, standard methods of access to the venous bed do not always allow us to effectively solve this problem. The capacity of peripheral and bone catheters is limited, which makes it difficult to quickly introduce «viscous» blood products.
The purpose of the study is to substantiate the choice of optimal venous access for prehospital stage in military field and emergency medicine for massive infusion and transfusion therapy, for which purpose to review the literature on international experience, to consider indications, contraindications and risks when using central vein catheterization for prehospital stage.
Materials and methods. A review of literary sources on keywords over the past 10 years has been conducted using databases eLibrary RU, PubMed and Google Scholar, 1286 sources were found, 24 sources were selected, of which 4 fully corresponded to the tasks set.
Results. The optimal solution is to central vein catheterization, which provides direct access to a larger diameter venous channel and allows for high-speed injection of blood products. The use of ultrasound navigation reduces the risks of central vein puncture and catheterization, increases the accuracy of manipulation and reduces the likelihood of complications, which justifies performing this procedure on prehospital stage even in difficult conditions.
Conclusion. Key factors determining success remain personnel qualification, environmental conditions, and the availability of appropriate equipment and logistical support.

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