I live in Ky and we can access any vein necessary, we just usually inform the Doc prior in case they want to put in a central line...$$$$$ Shoulder veins are great because they are seldom accessed and they are larger than they appear. Breast veins are also good just be sure you are accessing it correctly (flowing toward the heart). Why stick someone who has no peripheral veins when you can usually bet they have great EJs? We have a lot of IV drug users with no access peripherally so I just go right for the EJs and don't mess around, especially in drug overdoses! Have them turn their neck and puff out their cheeks and they pop up great!