Level 1 infuser IV access

CritterLover, BSN, RN · Mar 7, 2007

i work in a level 1 trauma center. what iv access and sites do you use for rapid infusion (level 1)? it seems some nurses and residents i work with think you can only infuse through a cordis in the sc. i realize this is the best case scenario, but why couldn't you infuse through a 18ga in the ac, or a tlc in the sc? i have found some literature saying this was ok but was looking for some real world experience. thanks

i've used the level 1 infuser though all of the above types of accesses, and never had a problem. important thing would be to watch the site closely, esp for a piv.

we usually used it through a cordis (usually fem, 'cause in those patients, the subclavian cordis usually had a pa catheter in it), but only becasue you will be able to achieve the highest infusion rates. but triple lumens work well (though not as fast), as do 18g and larger ivs that flush easily.

if you are using the level 1, you probably arn't going far, and keeping an eye on the iv site shouldn't be hard :)

of course, it would be very ugly to be using the level 1 though a piv and infiltrate a unit of blood through it (or a liter of fluid), maybe that is where they are coming from?

micker14 · May 22, 2011

We are going to start using a Level One infuser on my unit and I need to come up with the policy/procedures for it. If anyone could send me their policy for Level One infuser use in their unit that would be great!!!!! Kristine :up:

ICUenthusiast · May 22, 2011

I work in a Level 1 trauma center. What IV access and sites do you use for rapid infusion (Level 1)? It seems some nurses and residents I work with think you can only infuse through a cordis in the SC. I realize this is the best case scenario, but why couldn't you infuse through a 18ga in the AC, or a TLC in the SC? I have found some literature saying this was ok but was looking for some real world experience. Thanks

This is odd to me because the only patients with an actual cordis are on our CIC! Even then, they're often full with the swans and the other crap they need running. Of course, in a worst case scenario, you infuse what you can through what's available. Pretty sure we'll infuse through any large line available. If none, we start an 16 or 18g AC if possible. If the veins are collapsed too much or just a hard stick, physicians will place a TLC where they can.. even if it means a fem.

Mind you, a cordis is generally just a IJ central line (in my hospital at least, that's the only cordis we use).