Casualty as a Fluid Infusion Device: IV Bag Placement

Summary

This study was designed to identify the most effective underbody
position when using the patient’s own body weight as an
infusion device. Twenty volunteers had an air-less 500ml bag of
saline located at various under-body positions. Mean pressures
and flow rates through a 14G cannula were measured in vitro at
room temperature. Locating the fluid bag at the buttock cleft
delivered the highest mean flow rate at 135ml/min. This underbody position may provide flow rates sufficient to achieve the clinical aim of fluid resuscitation in the military pre-hospital
environment.

Fluid Infusion IV Bags

A dictum of tactical medicine is to carry equipment that has dual use. In the case of fluid infusion, medics are instructed to use their blood pressure cuffs or the patient if no other device is available. Medics have the option of carrying pre-made fluid infusers or an extra BP cuff, but the former violates the rule of dual use and the latter may be too bulky. The above article offers a valid, though not new, solution, because it explores the best location if a medic chooses to use the casualty.

2 replies
  1. starlight_cdn
    starlight_cdn says:

    That is excellent. Simple and it proves a true ‘ now, tested’ technique.

    Would there be any difference with flow rates on 250ml bags as HSD is issued in that manner? I realize that HSD should be tritrated over 250ml/15mins to control the affect to blood pressure esp TBI….

    Passing this one up the CoC.

    Reply
  2. mike
    mike says:

    I would be too worried about the evacuating personnel not seeing the iv bag, or during patient movement the bag wouldn’t flow due to bouncing or shifting of the patient. Also, some medics become very focused on what they see and might forget that the bag is underneath the patient. Good technique though, for more experienced personnel…

    Reply

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