Placement of 10-gauge catheter by cutdown for rapid fluid replacement

The establishment of immediate venous access and rapid fluid administration remains of paramount importance in the treatment of hypovolemic shock. We describe a technique for placement of a recently available 10-gauge catheter via venous cutdown. This technique is simpler and quicker than placing intravenous tubing directly into the vein, and we show that flow rates through the catheter with both saline and blood are equivalent to rates obtained through intravenous extension tubing. In addition, our studies show that the use of wide-bore intravenous tubing (urology irrigating tubing) instead of standard intravenous tubing allows for much higher infusion rates through the 10-gauge catheter. With the wide-bore tubing and pressure infusion, it is possible to administer 1,200 cc of blood per minute through this catheter.