Rapid fluid administration: an evaluation of two techniques

Abstract

ObjectiveRapid administration of fluid remains a cornerstone in treatment of shock and when caring for trauma patients. A range of devices and technologies are available to hasten fluid administration time. While new devices may optimize fluid delivery times, impact on subjective experience compared to traditional methods is poorly documented. Our study evaluated administration time and provider experience using two unique methods for fluid administration.Materials and methodsProspective comparison of objective and subjective outcomes using a novel infusion device (LifeFlow® Rapid Infuser) and the traditional push–pull syringe method in a simulated model of rapid fluid infusion. Ten paired trials were conducted for each of three intravenous catheter gauges. Providers administered 500 mL of isotonic crystalloid through an intravenous catheter with both LifeFlow and a push–pull device. Administration time was compared between devices using paired t-tests. Participants’ subjective physical demand, effort, pain, and fatigue using each device were recorded using 21-point visual analog scales and compared between devices using sign-rank tests.ResultsFluid administration time was significantly decreased with LifeFlow compared to the push–pull device with the 18-gauge catheter (2.5±0.8 vs 3.8±1.0 minutes; 95% CI of difference: 0.9, 1.8 minutes; P<0.001). Findings were similar for other catheter sizes. No improvements in subjective experience were noted with the LifeFlow device. Increased physical demand with the LifeFlow device was noted with 18 and 22 gauge catheters, and increased fatigue with the LifeFlow device was noted for all catheter sizes.ConclusionThe LifeFlow device was faster than the push–pull syringe method in our simulated scenario. However, provider subjective experience was not improved with the LifeFlow device.

A simulation study of high-flow versus normal-flow three-way stopcock for rapid fluid administration in emergency situations: A randomised crossover design

“…17 Using a novel infusion device (LifeFlow® Rapid Infuser) made initial fluid resuscitation faster than the push-and-pull technique, with statistical differences. 18 These methods reported in the aforementioned studies required equipment or some staff Table 1 Characteristics of the participants.…”

Case Reports: Rapid Fluid Delivery for Hypotension via a Novel Device (LifeFlow®) Leads to Improved Patient Outcome

“…It allows fluid bolus delivery at significantly faster speed than traditional infusion pumps, pressure bags, or gravity infusion, and may be less complex than powered rapid infusers [16]. In simulation studies, LifeFlow was associated with improved fluid delivery rate, decreased risk of aseptic technique violations, and decreased user fatigue [17][18][19].…”

The Use of a Rapid Fluid Infusion System in Children

“…The precise rate of fluid administration was often difficult to determine from chart review. Given the typical delivery times observed with LifeFlow usage, if no time was recorded 5 minutes was noted as the default time, based on several references documenting the delivery of 500-1000ml of crystalloid in less than 5 minutes [36][37][38][39] . Vital signs after fluid bolus was defined as the first set of vital signs immediately following the fluid bolus.…”