Daily Pearl 2/14

56 yo M PMH of cirrhosis comes in with upper GI bleed x 2 days. Initially with mild coffee ground emesis x 3 yesterday. Today, with 10 episodes of frank hematemesis. VS HR 144 BP 60/30 T 99.6 RR 22 O2 sat 96%. Massive transfusion protocol activated. Level 1 Rapid transfuser at bedside. What are the maximum infusion rates of our available vascular access devices?

standard pink IV:
20 gauge (.8 mm) x 30 mm angiocath
max flow rate = 60 ml / minute

standard green IV:
18 gauge (1 mm) x 30 mm angiocath
max flow rate = 105 ml / minute

standard grey IV:
16 gauge (1.3 mm) x 30 mm angiocath
max flow rate = 220 ml/min

procedural IV:
18 gauge x 64 mm angiocath
max flow rate = 85 ml/min

medial (blue) & proximal (white) lumen of triple lumen catheter:
18 gauge x 190 / 180 mm
max flow rate = 26 ml/min

distal (brown) lumen of triple lumen catheter:
16 gauge x 200 mm
max flow rate = 52 ml/min

cordis / introducer:
8.5 french (2.8 mm) x 100 mm
max flow rate = 126 ml / minute
max flow rate with pressure bag @ 300 mmHg: 333 ml / minute

From Emergency Medicine Updates. (Reuben Strayer)

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