LAUSR

S ecuring vascular access is crucial in the initial management and resuscitation of traumatically injured and critically ill patients. However, vascular access often can be difficult to obtain quickly. Patients who are dehydrated or in shock can have collapsed veins, and attempting to place a standard peripheral intravenous (IV) line can be time consuming or sometimes impossible. Peripheral IV placement can also be technically challenging in patientswith obesity, extensive burns, severe limb trauma, or sclerotic veins due to intravenous drug use. In these situations, alternatives to traditional peripheral IVs include a vein cutdown procedure, insertion of an intraosseous catheter, or placement of a central venous catheter. However, vein cutdowns require surgical expertise and are time consuming. Intraosseous catheters can be quickly placed, but require use of specialized equipment that may not be readily accessible in an emergency. Central line placement can be time consuming and is associated with a 4% to 17% complication rate, some of which can be severe such as arterial injury or pneumothorax. These vascular access alternatives are further limited in environments outside of a hospital. In men, the penis provides an easily accessible point of entry into the systemic vasculature. The primary penile vascular anatomy consists of the corpus spongiosum and the paired corpora cavernosa that engorgewith blood to achieve systolic blood pressure during normal erection. The corpora cavernosa contain a large pool of venous sinusoids that drain both directly and indirectly into large pelvic veins. At the root of the penis, the superficial dorsal vein of the penis drains into the saphenous vein. The deep dorsal penile vein drains into the periprostatic venous plexus, which in turn empties into the internal iliac vein. The proximal corpus cavernosum drains into the internal pudendal vein. Given these anatomic considerations, we hypothesized that the penis can be an efficient means by which to provide rapid fluid resuscitation. Previous studies have demonstrated the feasibility of this method of vascular access. In this study, we investigate achievable infusion flow rates through a standard 16-gauge peripheral angiocatheter inserted into a single corpus cavernosum.