Intravenous access in the critically ill trauma patient: a multicentered, prospective, randomized trial of saphenous cutdown and percutaneous femoral access.

Abstract:

STUDY OBJECTIVE:To compare the speed of IV access and the rate of infusion for saphenous venous cutdown and percutaneous femoral catheterization. DESIGN:Prospective, randomized, multicentered trial. Patient enrollment occurred from September 1990 through September 1991. SETTING:Patients were enrolled at three urban Level I trauma centers. TYPE OF PARTICIPANTS:Seventy-eight critically ill trauma patients. INTERVENTIONS:Participants were randomized to one of two groups: saphenous cutdown or percutaneous femoral line. After successful cannulation of the vein, 1 L of crystalloid was infused by gravity. RESULTS:The mean procedure time for the cutdown group was 5.63 +/- 2.58 minutes compared with 3.18 +/- 1.19 minutes for the femoral line group (P < .0001). The mean infusion time for the cutdown group was 6.65 +/- 4.29 minutes compared with 4.56 +/- 2.47 minutes for the femoral line group (P < .03). The mean overall time for the cutdown group was 11.76 +/- 4.81 minutes compared with 7.67 +/- 2.78 minutes for the femoral line group (P < .0002). CONCLUSION:Percutaneous femoral catheterization can be performed more rapidly than saphenous cutdown in the critically ill trauma patient with a palpable femoral pulse and allows for more rapid fluid administration. We support the use of a percutaneous femoral line as an acceptable alternative to saphenous venous cutdown in the initial resuscitation of trauma patients.

journal_name

Ann Emerg Med

authors

Westfall MD,Price KR,Lambert M,Himmelman R,Kacey D,Dorevitch S,Mathews J

doi

10.1016/s0196-0644(94)70074-5

subject

Has Abstract

pub_date

1994-03-01 00:00:00

pages

541-5

issue

3

eissn

0196-0644

issn

1097-6760

pii

S0196064494000090

journal_volume

23

pub_type

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