Description
Contributor: Travis Barlock, MD
Educational Pearls:
Gauge and length of catheter are determinants of flow rate Smaller gauges produce higher flow rate Longer catheters reduce flow rate Common IV gauges produce predictable rates of flow: 20 gauge = 60 cc/min 18 gauge = 105 cc/min 16 gauge = 220 cc/min Central lines typically have two 18 gauge and one 16 gauge lumen, both with long catheters, producing the following slower flow rates: 18 gauge = 26 cc /min 16 gauge = 55 cc/min Sheath Introducers, such as Cordis brand catheters, are wider and shorter than classic central lines. Flow rates are 150 cc/min, or 130 cc/min with pressure bag Maximal flow allows for one unit of blood to be delivered over one minute It is important to consider length and gauge of catheter when patients require fluids
References
Greene N, Bhananker S, Ramaiah R. Vascular access, fluid resuscitation, and blood transfusion in pediatric trauma. International Journal of Critical Illness and Injury Science. 2012;2(3):135. doi:10.4103/2229-5151.100890
Khoyratty SI, Gajendragadkar PR, Polisetty K, Ward S, Skinner T, Gajendragadkar PR. Flow rates through intravenous access devices: an in vitro study. J Clin Anesth. 2016;31:101-105. doi:10.1016/j.jclinane.2016.01.048
Summarized by Kirsten Hughes, MS4 | Edited by John Spartz, MD, & Erik Verzemnieks, MD
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Contributor: Travis Barlock MD
Educational Pearls:
Ketamine is an NMDA receptor antagonist with a wide variety of uses in the emergency department. To dose ketamine remember the numbers 0.3, 1, and 3.
Pain dose
For acute pain relief administer 0.3 mg/kg of ketamine IV over 10-20 minutes...
Published 04/22/24
Contributor: Travis Barlock MD
Educational Pearls:
Thrombolytic therapy (tPA or TNK) is often used in the ED for strokes
Use of anticoagulants with INR > 1.7 or PT >15
Warfarin will reliably increase the INR
Current use of Direct thrombin inhibitor or Factor Xa inhibitor
...
Published 04/15/24