Background Challenges to IV access outside the hospital The out-of-hospital setting can pose myriad challenges to the provider attempting to gain access to the intravascular compartment. In an individual patient encounter, placement of an intravenous (IV) catheter may be hampered by anatomy (e.g. venous collapse in hypotension), positioning (e.g. entrapment), and environmental conditions such as lighting and vehicular motion. These problems may be compounded in situations where multiple patients simultaneously require expedited IV access. Therefore, both "host" (i.e. patient) and "environment" (i.e. physical setting) parameters can contribute to a mismatch between desire for, and ability to achieve, access to the intravascular compartment.