Do you have Pressure Bags available on crash carts?

  1. We are debating if our crash carts should have pressure bags to run fluids at fast rates on coding patients. This is a debate based on control over infusions and patient safety. What do you do in a code and do you keep pressure bags on your crash carts? Help us wade through this debate. Thanks.
    •  
  2. 11 Comments

  3. by   nurseygrrl
    If you don't have the equiptment to monitor for possible fluid overload, you could push a pt. into CHF. I don't know what type of facility you work in, but it's not a good idea outside of a hospital in my opinion.
  4. by   traumaRUs
    In our level one trauma center ED we do have pressure bags but we don't use them for volume replacement - we use them for art lines. For volume - we have a Level One (brand name) rapid infuser.
  5. by   rjflyn
    We had them in our ER and used them. Have also used a BP cuff around the bag. Most ERs anymore have some type of rapid infuser so you are not giving pts liter upon liter of room temp fluids as this has been found to be detrimental to survival.

    Note to Hereyes73- if the pt is coding I dont think CHF is much of an issue and better to treat on a live pt.

    Rj
  6. by   nurhmb
    Quote from traumaRUs
    In our level one trauma center ED we do have pressure bags but we don't use them for volume replacement - we use them for art lines. For volume - we have a Level One (brand name) rapid infuser.
    We have a need to be able to provide fluids very quickly in a code situation. At present we have been running a bag of fluid with a pressure bad on it so that we can get max fluid in minimum time. How fast does the rapid infusor get in fluids in cc's per hour. Thaks so much for your response. It is so appreciated. nurhmb
  7. by   nurhmb
    Quote from HerEyes73
    If you don't have the equiptment to monitor for possible fluid overload, you could push a pt. into CHF. I don't know what type of facility you work in, but it's not a good idea outside of a hospital in my opinion.
    We are a hospital ICU. In occassional situations we need to run in fluids extremely fast in a minimal amouont of time. We have gone to putting a pressure bag on a bag of fluids and running it wide open. Our pumps only go to 999cc/hr. which is a liter in an hour and will not meet this emergency situation. As a result, we were wondering if the rest of the country kept pressure bags on their crash carts, ran fluids fast other ways, or whatever. Thanks for your response
  8. by   nurhmb
    Quote from rjflyn
    We had them in our ER and used them. Have also used a BP cuff around the bag. Most ERs anymore have some type of rapid infuser so you are not giving pts liter upon liter of room temp fluids as this has been found to be detrimental to survival.

    Note to Hereyes73- if the pt is coding I dont think CHF is much of an issue and better to treat on a live pt.

    Rj
    Please tell me what brand name rapid infusor that your facility uses. How fast does it deliver fluids? Thanks for responding.
  9. by   traumaRUs
    We use what is called a Level One rapid infuser and it infusers 1000cc in less than 10 minutes - so about 100cc/minute infusion rate. When we use it - we have one nurse dedicated to just priming bags and keeping track of the warmed fluids.
  10. by   nurhmb
    Quote from traumaRUs
    We use what is called a Level One rapid infuser and it infusers 1000cc in less than 10 minutes - so about 100cc/minute infusion rate. When we use it - we have one nurse dedicated to just priming bags and keeping track of the warmed fluids.
    Thank-you so much. We need to look into this piece of equipment. Do you know how I can contact someone involved in sales or manufacturing of this product?
  11. by   rjflyn
    I cant recall the brand of infuser we use, they had the level one prior to me working here and did away with it because of some issues, one being not monitoring infusion pressure very well. The one we use know has a large magnetic coil that goes in to it that heats the fluid,ie completely closed and uses no water for the heating media.


    Our protocol is no faster than 50cc/min flow rate on our rapid infuser. The theroy being any faster and you can cause significant venous damage - or inflitrate a large amount of fluid before you know it.. To see how fast it comes out put together a set and hook various size IV catheters to it, it is pretty amazing the pressure esp through an 18 ga which is the smallest one should ever use with the device.


    Rj
    Last edit by rjflyn on Jun 21, '04
  12. by   BJNurse
    Since I work in the cath lab we have pressure bags all over the place but I would definatley expect that there would be at least a couple on every crash cart. There are times that you need to provide a rapid fluid bolus and that is the quickest, easiest way to do it.(Unless you have a rapid infuser availabe which isn't pratical in most settings). The disposable pressure bags are only a few dollars so it shouldn't be to much problem to stock the facility with them. As far as fluid overload, at the point your breaking out the crash cart that of little concern!
  13. by   nurhmb
    Quote from BJNurse
    Since I work in the cath lab we have pressure bags all over the place but I would definatley expect that there would be at least a couple on every crash cart. There are times that you need to provide a rapid fluid bolus and that is the quickest, easiest way to do it.(Unless you have a rapid infuser availabe which isn't pratical in most settings). The disposable pressure bags are only a few dollars so it shouldn't be to much problem to stock the facility with them. As far as fluid overload, at the point your breaking out the crash cart that of little concern!
    Thanks for the idea of the disposable for the crash carts. We are a small community rural hospital and when the time comes and we get our first power injector, I am sure it will go to the ER.....but I will start awareness on power injectors now for the future. The respones on this question have been very helpful.

close