To the Editor:--It is not uncommon for intravenous access to be difficult because a patient has severe vasoconstriction or a poor superficial venous system. Sometimes, application of a warm compress over the patient's hand will dilate the veins sufficiently. The following is another technique that may assist in cannulating peripheral veins, without resorting to a central venous route. If a patient arrives in the operating room with a 25G needle in place, use it. If not, try inserting a 22G or a 25G needle anywhere you can find a vein. After ensuring the intravenous line is functioning, apply a venous tourniquet to the upper arm and infuse 50–100 ml of intravenous solution with a 10 ml syringe. One will be pleasantly surprised to find the patient's veins unexpectedly accessible.

Koretada Kondo, MD; Department of Anesthesiology, St. Vincent's Medical Center, Bridgeport, Connecticut 06606.

(Accepted for publication May 6, 1996.)