We got a lot of questions after round 1 of the large bore IV access showdown, mainly about the effect of points of narrowing that may be introduced to your fluid administration lines.
So we set up round 2, testing the effect of a fluid warmer, an IV bung and a 3-way tap on flow rates through an 8.5Fr RIC line attached to a high pressure rapid infuser system.
We also dismantle an IV bung to see just why they slow flow so much!
Check out the video to see the results.
Posted in Vascular AccessFor decades now we’ve all been reciting the mantra that any sick or shocked patient needs:
We’ve also all been taught that “short and thick does the trick” due to Poiseuille’s Law which states that flow is directly proportional to the fourth power of the radius, and inversely proportional to the length:
But despite our best efforts we couldn’t find a direct comparison of the various types of IV cannulas and catheters we used at work to see which one is actually best. We had unanswered questions that needed answers.
Which IV cannula/catheter delivers IV fluid the fastest?
How much faster is a 14G compared to a 16G, 18G or 20G?
Is a standard 14G faster than a RIC line or sheath introducer?
And just how much slower is a central line at delivering fluid?
Behold, the Large Bore IV Access Showdown. We’ve hooked up all of the major types of IV lines you’re likely to find in an average Australian ED to a rapid infusor device, and timed how long it took to pump through a litre of saline.
So which line was best? You’ll have to watch the video and find out!
(If you can’t stand the wait, skip ahead to the results at the 10:40 mark)
Here’s our video on how to insert a RIC line
Here’s our rather unscientific, but hopefully visually useful comparison of the relative speeds at which fluid can be pumped through the different lines in our test:
Click to enlarge
And here’s our table of results:
Please feel free to download, share, embed, or otherwise distribute the video and results. And feel free to run your own trials and let us know if they’re similar or different!
For more information on the various types of large bore IV access check out our post on the ETM Course site on large bore vascular access devices. The astute will have noticed that we didn’t use a MAC-line (multi-lumen access catheter) in this test. This was because we don’t stock them in the ED we did the test in, and they are rarely (if ever) found in your average Australian ED, however most if not all of the other lines are.
Posted in Vascular AccessThis is a quick video I did over at the ETM Course blog. If you don’t now about RIC lines (rapid infuser catheters), watch this video, and read my other post about large bore vascular access devices!
Posted in Vascular AccessThis is a great video demonstrating ultrasound guided radial artery line insertion. I’d recommend watching until the end for the troubleshooting tips and tricks. I’ve been doing radial artery lines for over a decade and didn’t know some of these simple tricks for what to do when you’ve hit the artery but the cannula won’t feed, this will surely save you and your patients much frustration in the future!
Posted in Vascular AccessHeld in central Melbourne, this 1-day course will allow advanced ACEM/ACRRM/RACGP trainees, ACEM Certificate & Diploma candidates, FACEMs and GPs to learn and practice a wide range of critical ED procedures in one day.
COURSE DETAILS