IV and Lines

roller clamp:

dial-a-flow:

Flow Rates

max flow rate in cc/min
massive transfusion: 150 cc/min
- 2 large IV: 18+20 or 16
IO: typically 18
French sizes are larger than gauge and starts from 4F after 16G
Triple lumen: flow rate is decreased because increased length, total 100 cc/min:

IV infusion can be done via 2 ways
- gravity with roller clamp, dial-a-flow
- infusion pump

Non-tunneled catheter: usually what we think as central lines. E.g. triple lumen. The line comes out of skin where it is inserted.
Tunneled catheter: passes under the skin with separate exit site, usually the chest. Tunneling helps prevent infection and improves stability
Cuffed catheter: cuff that allows skin to grow around it
Triple Lumen: usually non tunneled three lumen catheter. Usually has one 16G and two 18G. Usually 7 French.
Vas cath: aka HD cath, large diameter catheters, up to 16 French, allow flow rate 200-300 cc/min, usually has 2 lumen, one for blood coming out and one for blood returning to patient
PICC: smaller diameter and longer than CVC. Unsuitable for rapid, large fluid.
Tunneled cuffed central lines: used for long term access (weeks to months) such as chemo, nutrition, fluid. E.g. PowerlIne.

For contrast injection, the line must be able to withstand high flow rate of up to 5 cc/s or 300cc/min
PIV: Ideally 20G or larger. IJ or EJ IV should not be used
PICC: will be marked "power injectable"
Chest Port: Usually power injectable
Central line: usually can be used for contrast injection
- Arrowgard Blue is pressure injectable with max ml/sec marked on catheter
Dialysis catheter: cannot be used for power inject except BARD Trialysis catheter (vas cath with pigtail).