Micro-Stick to Rapid Infusion Catheter (RIC): Ultrasound-Guided Rapid Infusion Catheter Insertion Using a Micropuncture Kit

Abstract

Ultrasound-guidance improves success for difficult intravenous access (DIVA), particularly when difficulty is anticipated. However, insertion of a wide-bore sheath, such as a rapid infusion catheter, is likely to pose additional problems and unique challenges in this context, despite ultrasound guidance. With the aid of a video clinical simulation, this article describes an ultrasound-guided technique for inserting a proprietary rapid infusion catheter (RIC) or similar wide-bore sheath using the micropuncture kit.

The Adult Difficult Intravenous Access (DIVA) Cognitive Aid: An Evidence-Based Cognitive Aid Prototype for Difficult Peripheral Venous Access

“…Previous guidelines for DIVA have focused heavily on direct puncture and ultrasound [16]. While much has been written on Seldinger techniques for vascular access in general [22,24,27,[44][45][46][47][48][49][50][51][52][53], previous protocols have not assimilated evidence-based Seldinger techniques for DIVA. Indeed, there is a growing armamentarium of techniques now published, such as those included in Figure 1.…”

“…Micropuncture kits including the 4-Fr to 5-Fr 10 cm Micropuncture® Access Set (Cook Medical, Bloomington, IN, USA) and V•Stick™ Vascular Access Set (Argon Medical, Plano, TX) are useful for DIVA [52], and offer the added benefit that they can be serially upsized to wide-bore sheaths, including a rapid infusion catheter (RIC®) (Arrow® International, Morrisville, NC, USA) [53]. They are purpose-designed to accommodate a 0.038-inch (0.89 mm) wire, allowing a range of coaxial-dilator-mounted percutaneous sheaths to be introduced.…”