How should IV access be established in acute head injury management?

• A. Central venous catheter
• B. One large-bore catheter
• C. Two large-bore catheters
• D. No IV access needed

Answer: (C)

Two wide-bore peripheral IV lines should be established quickly in acute head injury because rapid access is essential for timely resuscitation and treatment. Having two large-bore lines allows immediate high-volume fluid administration, blood products if needed, and simultaneous delivery of multiple medications (analgesia, sedation, hyperosmolar therapy, antibiotics, etc.) without bottlenecking at a single line. This setup supports maintaining adequate cerebral perfusion while you manage other critical steps.

A central venous catheter is not the preferred initial choice because placing it takes more time and carries higher risks (infection, pneumothorax) in the urgent setting. One line may become a limitation if large volumes or several drugs must be given at once, whereas two lines provide the speed and flexibility required during initial resuscitation. No IV access is inappropriate because rapid vascular access is a cornerstone of managing head injury effectively.