الفهرس 
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Abstract
Effective venous access is essential for the resuscitation and management of trauma patients. The anathesiologist should be skilled in the various catheterization techniques available . Cannulation of the venous system is either peripheral or central.Peripheral venous cannulation can be done for any visible or palpable veins, however certain sites are preferable such as dorsal venous arch of the hand and long veins of the forearm Cannulation of peripheral veins may be complicated by infection, thrombosis and fluid extravasation, so the cannula site should be inspected before use. Central venous cannulation is indicated for administration of irritant drugs, vasoactive agents and total parentral nutrition, also for measurement of central venous pressure and in case of difficult peripheral access. .The common sites are internal jugular, subclavian and femoral veins with different approaches for each one, but this access has serious complications during insertion and maintenance which may be mechanical, infectious and thromboembolic complication.. Arterial cannulation is very important in the critically ill patient, because it allows the monitoring of moment to moment variations in blood pressure and to avoid injury from frequent arterial blood sampling. The arterial cannulation may be complicated by limb ischemia, haemorrhage and infection .