A new method for rapid fluid bolus infusion into a peripheral vein

To compare the flow rates achieved by a new short-tubed infusion device with those obtained with a conventional apparatus, using gravity, manual pressure, and pneumatic inflation as the driving forces.

Ten paramedic volunteers were recruited for this prospective, randomized, controlled laboratory study. For the short-tubing setup, a new device, the port, was used to adapt standard 18-cm extension tubing directly to an i.v. bag [short tubing/port (STP) setup]. For the conventional (CON) setup, 280-cm tubing was used. Both study setups were tested on each of the volunteers with flow from a standard 250-mL bag of normal saline subjected to three types of driving force: 1) gravity alone, 2) pressure supplied by two hands squeezing the i.v. bag, and 3) a pneumatic pressure bag continuously inflated to 300 mm Hg. The mean flow rates for each driving force were compared between the two setups.

Using gravity flow, no significant difference was noted between the STP setup and the CON setup (0.40 vs 0.45 mL/sec, respectively, p > 0.4). However, when flow was augmented by pressure supplied by two hands squeezing the bag, mean flow was greater for the STP setup than for the CON setup (4.5 vs 2.7 mL/sec, respectively, p < 0.001). When flow was augmented by a pneumatic bag at 300 mm Hg, mean flow was again greater for the STP setup (5.6 mL/sec) than for the CON setup (3.3 mL/sec, p < 0.001).

Flow of crystalloid under pressure into a peripheral vein is markedly increased with the new STP setup as compared with the CON setup. Incorporation of this new setup in prehospital care would allow EMS personnel to infuse fluid more rapidly and conveniently during transport.