Intensive Care Medicine (ICM) Practice Exam

Which vein is the most suitable for intravenous cannulation?

1. Vena mediana cubiti on right upper extremity

2. Vena cephalica on left upper extremity

3. Vena basilica on left upper extremity

4. Vena cephalica or vena basilica on right upper extremity

The correct answer is: Vena cephalica or vena basilica on right upper extremity

The choice of vein for intravenous cannulation is primarily based on anatomical accessibility, size, and reliability. The cephalic and basilic veins are both large, typically superficial veins located in the upper extremities, making them suitable for IV access. Cannulating the cephalic or basilic vein on the right upper extremity allows for easy access and visibility, which is crucial in an intensive care setting where rapid infusion may be necessary. The cephalic vein runs laterally along the arm, while the basilic vein runs medially, and both are usually well-placed for the insertion of an IV line. Choosing either of these veins on the right side provides flexibility if one vein is not suitable for whatever reason (e.g., thrombosis, tortuosity, or a previous cannulation site). This bilateral accessibility enhances the chances of successful cannulation. In comparison, while the median cubital vein is also often used for IV access, its position is slightly deeper and can vary significantly among patients. The median cubital vein may not always present as reliably accessible as the cephalic or basilic veins. Therefore, opting for the cephalic or basilic veins on the right upper extremity is considered the most suitable strategy for intravenous cann