Rapid infusion catheter: Difference between revisions
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*8.5 Fr diameter, 6.5 cm long infusion catheter | *8.5 Fr diameter, 6.5 cm long infusion catheter | ||
*Designed to be exchanged through a 20-gauge PIV via Seldinger technique | *Designed to be exchanged through a 20-gauge PIV via Seldinger technique | ||
*Can achieve flow rates >600 ml/min with pressure (higher than a [[sheath introducer]] or 14-gauge PIV | *Can achieve flow rates >600 ml/min with pressure (higher than a [[sheath introducer]] or 14-gauge PIV)<ref>Brown, N., Kaylene M. Duttchen, and J. W. Caveno. "An evaluation of flow rates of normal saline through peripheral and central venous catheters." American Society of Anesthesiologists Annual Meeting, Orlando. Anesthesiology. 2008.</ref> | ||
*Placed under antiseptic technique | |||
==Indications== | ==Indications== | ||
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==Contraindications== | ==Contraindications== | ||
===Absolute=== | |||
*Infection over the placement site | |||
*Anatomic obstruction (thrombosis of target vein, other anatomic variance) | |||
===Relative=== | |||
*Coagulopathy | |||
*Distortion of landmarks by trauma or congenital anomalies | |||
*Prior vessel injury or procedures | |||
==Equipment Needed== | ==Equipment Needed== | ||
*Arrow brand RIC set | |||
**RIC line with dilator | |||
**Wire | |||
**Scalpel | |||
*Pre-existing PIV (at least 20-gauge or larger bore) | |||
*Suture material | |||
*[[Local anesthetics|Local anesthetic]] | |||
==Sites== | |||
*Ideally want 6-8 cm of relatively straight vein: | |||
**Cephalic or basilic veins in cubital fossa | |||
**Cephalic vein of forearm | |||
**Saphenous vein | |||
**External jugular vein | |||
==Procedure== | ==Procedure== | ||
#Remove PIV dressing | |||
#Inject local anesthetic to surrounding tissue | |||
#Remove buff cap and apply proximal pressure to avoid blood loss | |||
#Feed wire through PIV | |||
#Feel RIC catheter over wire | |||
#Use scalpel to "nick" the skin | |||
#Remove dilator and wire while applying proximal pressure to avoid blood loss | |||
#Stitch to skin and apply dressing | |||
==Complications== | ==Complications== | ||
*Bleeding/hematoma | |||
*Failure to place (with loss of existing IV access and local tissue infiltration) | |||
*Thrombosis, thrombophlebitis, vessel perforation | |||
*Skin necrosis if dilator not removed prior to infusion<ref>Chou W H, Rinderknecht T N, Mohabir P K, et al. (January 08, 2019) Skin Necrosis Distal to a Rapid Infusion Catheter: Understanding Possible Complications of Large-bore Vascular Access Devices. Cureus 11(1): e3854. doi:10.7759/cureus.3854</ref> | |||
==See Also== | ==See Also== | ||
{{Template:Vascular access types}} | |||
==External Links== | ==External Links== | ||
*https://derangedphysiology.com/main/required-reading/equipment-and-procedures/Chapter%202.2.3/rapid-infusion-catheter-ric | *[https://derangedphysiology.com/main/required-reading/equipment-and-procedures/Chapter%202.2.3/rapid-infusion-catheter-ric Deranged Physiology: The rapid infusion catheter (RIC)] | ||
*https://etmcourse.com/large-bore-vascular-access-devices/ | *[https://etmcourse.com/large-bore-vascular-access-devices/ ETM Course: Large bore vascular access devices] | ||
*[https://aci.health.nsw.gov.au/networks/eci/clinical/clinical-resources/procedures/procedures/575484 Emergency Care Institute: Circulation - Rapid infusion catheter (RIC)] | |||
*[https://stmungos-ed.com/lines-catheters/ric St. Mungo's: Rapid Infusion Catheter] | |||
==References== | ==References== | ||
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[[Category:Procedures]] | [[Category:Procedures]] | ||
[[Category:Critical Care]] |
Latest revision as of 17:04, 18 February 2021
Overview
- 8.5 Fr diameter, 6.5 cm long infusion catheter
- Designed to be exchanged through a 20-gauge PIV via Seldinger technique
- Can achieve flow rates >600 ml/min with pressure (higher than a sheath introducer or 14-gauge PIV)[1]
- Placed under antiseptic technique
Indications
- Vascular access
- Rapid large-volume fluid or blood administration
Contraindications
Absolute
- Infection over the placement site
- Anatomic obstruction (thrombosis of target vein, other anatomic variance)
Relative
- Coagulopathy
- Distortion of landmarks by trauma or congenital anomalies
- Prior vessel injury or procedures
Equipment Needed
- Arrow brand RIC set
- RIC line with dilator
- Wire
- Scalpel
- Pre-existing PIV (at least 20-gauge or larger bore)
- Suture material
- Local anesthetic
Sites
- Ideally want 6-8 cm of relatively straight vein:
- Cephalic or basilic veins in cubital fossa
- Cephalic vein of forearm
- Saphenous vein
- External jugular vein
Procedure
- Remove PIV dressing
- Inject local anesthetic to surrounding tissue
- Remove buff cap and apply proximal pressure to avoid blood loss
- Feed wire through PIV
- Feel RIC catheter over wire
- Use scalpel to "nick" the skin
- Remove dilator and wire while applying proximal pressure to avoid blood loss
- Stitch to skin and apply dressing
Complications
- Bleeding/hematoma
- Failure to place (with loss of existing IV access and local tissue infiltration)
- Thrombosis, thrombophlebitis, vessel perforation
- Skin necrosis if dilator not removed prior to infusion[2]
See Also
Vascular access types
- Central venous catheterization
- Rapid infusion catheter
- Intraosseous access
- Venous cutdown
- Umbilical vein catheterization
- Ultrasound assisted peripheral line placement
- External jugular vein cannulation
- The "Easy IJ"
- Midlines
External Links
- Deranged Physiology: The rapid infusion catheter (RIC)
- ETM Course: Large bore vascular access devices
- Emergency Care Institute: Circulation - Rapid infusion catheter (RIC)
- St. Mungo's: Rapid Infusion Catheter
References
- ↑ Brown, N., Kaylene M. Duttchen, and J. W. Caveno. "An evaluation of flow rates of normal saline through peripheral and central venous catheters." American Society of Anesthesiologists Annual Meeting, Orlando. Anesthesiology. 2008.
- ↑ Chou W H, Rinderknecht T N, Mohabir P K, et al. (January 08, 2019) Skin Necrosis Distal to a Rapid Infusion Catheter: Understanding Possible Complications of Large-bore Vascular Access Devices. Cureus 11(1): e3854. doi:10.7759/cureus.3854