Are air inlets necessary with Haemaccel?

Haemaccel is often used for the resuscitation of shocked patients. It is common practice to introduce an air inlet into the plastic container to increase the flow rate. We investigated how much difference an air inlet made. We compared the flow rates with no air inlet, a single air inlet, a 2 x 2 cm hole (equivalent to multiple air inlets) and a pressure infusion cuff. Although the use of an air inlet compared with no air inlet reduced the time to infuse 500 ml by 27 s, the difference was only clinically significant over the final 100 ml. A pressure cuff produced the fastest flow, reducing the time by 68 s. Use of an air inlet, however, precludes subsequent use of a pressure cuff. We recommend that the practice of using air inlets for Haemaccel and other similarly packaged products is abandoned.