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RICsy Business: A Tutorial on Rapid Infusion Catheter Placement and Utilization in Emergency Medicine
Jace C Bradshaw1, David J Berman2, David Leon1
1Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Background:
In emergency medicine (EM), high-volume fluid resuscitation is often crucial to stabilize critically ill patients. This tutorial aims to provide emergency physicians with a comprehensive guide on the placement and utilization of Rapid Infusion Catheters (RICs)-a large bore peripheral IV inserted by modified Seldinger technique-in emergencies.
Discussion:
We introduce the RIC as a resuscitation tool, describe a clinical scenario ideal for RIC placement, and provide a step-by-step guide for RIC placement. We briefly discuss the pathophysiology of hypovolemic states and how rapid correction can improve cardiac function. Additionally, we discuss the determinants of intravenous (IV) flow rates and explain why RICs offer superior flows in critical scenarios.
Conclusions:
Rapid Infusion Catheters are useful tools in resuscitative medicine but are underutilized in the emergency department.
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