In-Reply-To: <[log in to unmask]>
> 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.
No, in the overwhelming majority of cases. You'll be doing well to get
that much in; Keith Little's study suggested that on average 276 ml (IIRC)
was infused before the patient reached hospital.
> Do you think that introducing a smaller cannula would reduce on scene
> time?
> (see benfits of 18g on original e-mail)
Insignificantly.
> 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?
Not to the veins; there may be turbulent erythrocyte destruction. This is
commonly seen when aspirating blood. As you are not giving blood this is a
non-starter.
> Rowley,
>
> Penetrating vs Blunt trauma. Some in the UK camp say that fluids are
> good
> for blunt trauma. As we get more blunt trauma than penetrating trauma is
> fluids good? Paramedics don't know and until such the debate across the
> pond
> is settled then the policy makers will not change our protocols and it
> would
> be stupid for any paramedic to go against existing IHCD or Local
> protocols.
> It opens one up to serious ramifications.
>
> Mike Bjarkoy
> Paramedic
> Sunny Sussex
>
I think that I have covered this in the other posting.
Best wishes,
Rowley Cottingham
[log in to unmask]
Boy, I'm tired tonight! (This autosig will be changed when the statement
is no longer true!)
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