Rapid infusion catheter
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
- Vascular access
- Rapid large-volume fluid or blood administration
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
- 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
- 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
- Central venous catheterization
- Rapid infusion catheter
- Intraosseous access
- Venous cutdown
- Umbilical vein catheterization
- Ultrasound assisted peripheral line placement
- External jugular vein cannulation
- The "Easy IJ"
- Midlines
External Links
- Deranged Physiology: The rapid infusion catheter (RIC)
- ETM Course: Large bore vascular access devices
- Emergency Care Institute: Circulation - Rapid infusion catheter (RIC)
- St. Mungo's: Rapid Infusion Catheter
References
- ↑ 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.
- ↑ 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