- rapid infusion catheter (RIC)
- rapid IV fluid and blood product administration
- venous catheter — short, wide bore, can be sutured in
- dilator (catheter slides off this)
METHOD OF INSERTION
- IV cannular inserted
- Seldinger technique
- dilation and insertion of line
- suture or dressed in place
- insert 20G or larger standard cannula
- insert RIC guidewire thorough cannula
- remove cannula and proceed with RIC line insertion using in situ guidewire
Principle of use
Flow = change in pressure/resistance Flow = change in pressure x radius4/length (simplified Poiseuilles formula)
Flow determined by
- pressure gradient
- length of catheter
- radius to the power of 4
Thus, for the fastest infusion you need a large pressure gradient, short catheter and large bore line
- usual complications of IV access devices
- failure to remove the dilator following catheter insertion
- failure to rewire a cannula (if <20G cannulae)
References and Links
FOAM and web resources
- ETM — How to save a life with a 20G IV – JAMIT Video (2013)
Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also a Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.
After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.
He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE. He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.
His one great achievement is being the father of three amazing children.
On Twitter, he is @precordialthump.