Rapid infusion catheter: Difference between revisions

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==Overview==
==Overview==
 
*8.5 Fr diameter, 6.5 cm long infusion catheter
*Can achieve flow rates >600 ml/min with pressure<ref>Brown, N., Kaylene M. Duttchen, and J. W. Caveno. "An evaluation of flow rates of normal saline through peripheral and central venous catheters." American Society of Anesthesiologists Annual Meeting, Orlando. Anesthesiology. 2008.</ref>
*Designed to be exchanged through a 20-gauge PIV via Seldinger technique
*Can achieve flow rates >600 ml/min with pressure (higher than a [[sheath introducer]] or 14-gauge PIV)<ref>Brown, N., Kaylene M. Duttchen, and J. W. Caveno. "An evaluation of flow rates of normal saline through peripheral and central venous catheters." American Society of Anesthesiologists Annual Meeting, Orlando. Anesthesiology. 2008.</ref>
*Placed under antiseptic technique


==Indications==
==Indications==
 
*[[Vascular access]]
*Rapid large-volume fluid or blood administration


==Contraindications==
==Contraindications==
===Absolute===
*Infection over the placement site
*Anatomic obstruction (thrombosis of target vein, other anatomic variance)


===Relative===
*Coagulopathy
*Distortion of landmarks by trauma or congenital anomalies
*Prior vessel injury or procedures


==Equipment Needed==
==Equipment Needed==
*Arrow brand RIC set
**RIC line with dilator
**Wire
**Scalpel
*Pre-existing PIV (at least 20-gauge or larger bore)
*Suture material
*[[Local anesthetics|Local anesthetic]]


==Sites==
*Ideally want 6-8 cm of relatively straight vein:
**Cephalic or basilic veins in cubital fossa
**Cephalic vein of forearm
**Saphenous vein
**External jugular vein


==Procedure==
==Procedure==
 
#Remove PIV dressing
#Inject local anesthetic to surrounding tissue
#Remove buff cap and apply proximal pressure to avoid blood loss
#Feed wire through PIV
#Feel RIC catheter over wire
#Use scalpel to "nick" the skin
#Remove dilator and wire while applying proximal pressure to avoid blood loss
#Stitch to skin and apply dressing


==Complications==
==Complications==
 
*Bleeding/hematoma
*Failure to place (with loss of existing IV access and local tissue infiltration)
*Thrombosis, thrombophlebitis, vessel perforation
*Skin necrosis if dilator not removed prior to infusion<ref>Chou W H, Rinderknecht T N, Mohabir P K, et al. (January 08, 2019) Skin Necrosis Distal to a Rapid Infusion Catheter: Understanding Possible Complications of Large-bore Vascular Access Devices. Cureus 11(1): e3854. doi:10.7759/cureus.3854</ref>


==See Also==
==See Also==
 
*[[Rapid infusion systems]]
{{Vascular access types}}


==External Links==
==External Links==
*https://derangedphysiology.com/main/required-reading/equipment-and-procedures/Chapter%202.2.3/rapid-infusion-catheter-ric
*[https://derangedphysiology.com/main/required-reading/equipment-and-procedures/Chapter%202.2.3/rapid-infusion-catheter-ric Deranged Physiology: The rapid infusion catheter (RIC)]
*[https://etmcourse.com/large-bore-vascular-access-devices/ ETM Course: Large bore vascular access devices]
*[https://aci.health.nsw.gov.au/networks/eci/clinical/clinical-resources/procedures/procedures/575484 Emergency Care Institute: Circulation - Rapid infusion catheter (RIC)]
*[https://stmungos-ed.com/lines-catheters/ric St. Mungo's: Rapid Infusion Catheter]


==References==
==References==
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[[Category:Procedures]]
[[Category:Procedures]]
[[Category:Critical Care]]

Latest revision as of 21:24, 17 July 2024

Overview

  • 8.5 Fr diameter, 6.5 cm long infusion catheter
  • Designed to be exchanged through a 20-gauge PIV via Seldinger technique
  • Can achieve flow rates >600 ml/min with pressure (higher than a sheath introducer or 14-gauge PIV)[1]
  • Placed under antiseptic technique

Indications

Contraindications

Absolute

  • Infection over the placement site
  • Anatomic obstruction (thrombosis of target vein, other anatomic variance)

Relative

  • Coagulopathy
  • Distortion of landmarks by trauma or congenital anomalies
  • Prior vessel injury or procedures

Equipment Needed

  • Arrow brand RIC set
    • RIC line with dilator
    • Wire
    • Scalpel
  • Pre-existing PIV (at least 20-gauge or larger bore)
  • Suture material
  • Local anesthetic

Sites

  • Ideally want 6-8 cm of relatively straight vein:
    • Cephalic or basilic veins in cubital fossa
    • Cephalic vein of forearm
    • Saphenous vein
    • External jugular vein

Procedure

  1. Remove PIV dressing
  2. Inject local anesthetic to surrounding tissue
  3. Remove buff cap and apply proximal pressure to avoid blood loss
  4. Feed wire through PIV
  5. Feel RIC catheter over wire
  6. Use scalpel to "nick" the skin
  7. Remove dilator and wire while applying proximal pressure to avoid blood loss
  8. Stitch to skin and apply dressing

Complications

  • Bleeding/hematoma
  • Failure to place (with loss of existing IV access and local tissue infiltration)
  • Thrombosis, thrombophlebitis, vessel perforation
  • Skin necrosis if dilator not removed prior to infusion[2]

See Also

Vascular access types

External Links

References

  1. ↑ Brown, N., Kaylene M. Duttchen, and J. W. Caveno. "An evaluation of flow rates of normal saline through peripheral and central venous catheters." American Society of Anesthesiologists Annual Meeting, Orlando. Anesthesiology. 2008.
  2. ↑ Chou W H, Rinderknecht T N, Mohabir P K, et al. (January 08, 2019) Skin Necrosis Distal to a Rapid Infusion Catheter: Understanding Possible Complications of Large-bore Vascular Access Devices. Cureus 11(1): e3854. doi:10.7759/cureus.3854
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