Blood bank number: 5-6260
BCH Massive Transfusion Policy
BCH Massive Transfusion Summary
BCH Blood Product Reference Tool
Blood Compatibility Table
Rapid infuser key points
- Use the rapid infuser in patients above 10 kg with significant bleeding.
- The rapid infuser requires
- A dedicated, large bore catheter, preferably a RIC (rapid infusion catheter) line. Do NOT use with a central venous catheter, as the bores of even the largest catheter are excessively small.
- A dedicated nurse and/or physician to track volume administered and maintain adequate intake.
- CAN administer crystalloid (normal saline, Lactated Ringers, PlasmaLyte A), packed red blood cells, fresh frozen plasma.
- CANNOT administer platelets, cryoprecipitate, or medications via the rapid infuser.
Instructional video
Maximum flow rates (mL/min)
Arrow Rapid Infusion Catheter (RIC)
| Catheter size | Lumens | Lumen gauge sizes | Maximum flow rate (mL/min) |
| 7 Fr | Single | 13.3 ga | 1,137 |
| 8.5 Fr | Single | 11.8 ga | 1,200 |
Peripheral IVs
| Hub color | Gauge | Maximum flow rate (mL/min) |
| Yellow | 24 | 17 |
| Blue | 22 | 35 |
| Pink | 20 | 60 |
| Green | 18 | 105 |
| Gray | 16 | 220 |
| Orange | 14 | 330 |
Cook Percutaneous Catheters
| Catheter size | Lumens | Lumen gauge sizes | Average gravity flow rate (mL/min) |
| 4 Fr | Double | 20 ga/22 ga | 23 (distal) or 12 (proximal) |
| 5 Fr | Double | 20 ga/20 ga | 20 (distal) or 15 (proximal) |
| 5 Fr | Triple | 18 ga/23 ga/23 ga | 20 (distal) or 2 (proximal) |
| 7 Fr | Triple | 16 ga/18 ga/18 ga | 49 (distal) or 20 (proximal) |
Bard PowerPICC Catheters
| Catheter size | Lumens | Lumen gauge sizes | Average gravity flow rate (mL/min) |
| 4 Fr | Single | 18 ga | 21.2 |
| 5 Fr | Single | 18 ga | 19.8 |
| 5 Fr | Double | 18 ga/18 ga | 9.6 |
| 6 Fr | Double | 18 ga/18 ga | 12.6 |
| 5 Fr | Triple | 18 ga/20 ga/20 ga | 16.3/2.2 |
| 6 Fr | Triple | 17 ga/19 ga/19 ga | 19.4/4.6 |
Sources
Wrenn, et al. Comparison of Flow Dynamics of Peripherally and Centrally Inserted Intravenous Catheters Using a Rapid Infusion System (ThermaCor 1200). AANA Journal. 2017; 85, 4: 256-260. [PDF]
Greene N, Bhananker S, Ramaiah R. Vascular access, fluid resuscitation, and blood transfusion in pediatric trauma. Int J Crit Illn Inj Sci 2012;2:135-42 [PDF]
Bard PowerPICC package insert
Cook catheter vascular catheter package insert [PDF]