-----Original Message-----
From: Michael Bjarkoy <[log in to unmask]>
To: [log in to unmask] <[log in to unmask]>
Date: 15 June 1999 18:58
Subject: RE: Size Matters??
To Carlos, Rowley and Stephen
THE ORIGINAL QUESTION.
If I infused via an 18g cannula rather than a 14g cannula would there be any
detrimental effects on the patient or problems for the receiveng doctors
because of the choice of cannula. Taking into accout that our arrival on
scene time to arrival at hospital time is usually 20 to 25 minutes which is
enough time to infuse 2000mls of hartmans.
Do you think that introducing a smaller cannula would reduce on scene time?
(see benfits of 18g on original e-mail)
Is there a problem with damage to veins by turbulance (see Stephens e-mail
reply) is fluid go through a smaller cannula at a greater pressure?
Stephen,
We (the group) talk of hypotensive therapy. In this case the pateint may
enter AEU with NO cannula at all. I understand that you may be able to IV
access brown cannula's very successfully, but could you say that about all
of your collegues. If the answer is no then as a comprimise what about the
green cannula's. Easier to get in for most people, therefore hopefully
quicker (reduce on scene times) and you get some fluids into the patient.
One can put them in distally and this leaves the big ACF's free for the
Dr's.
Wot do ya fink?? Garbage? is so why?
Yes, I often take patients in with no cannula. I then get asked where the
cannula is, because the patient has now crashed and they have to do a
central line with all it's complications. How much easier it would be if
they had a nice big cannula in situ, with or without fluids hanging.
Sure, not all paramedics are as good at cannulation as others, but why
should that stop me doing what I can do? Yes, a green cannula is almost as
good as a brown, but either way, scene time should not be increased whatever
is used, because cannulation is carried out en-route to hospital. It is
airway, c-spine, breathing and immobilisation before moving.
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
|