Massive Infusion Device Use
A massive infusion device is a mechanical device that’s used in patients who need rapid fluid replacement with blood products and IV fluids. Patients with life-threatening conditions, such as severe trauma, gastrointestinal hemorrhage, postoperative hemorrhage, septic shock, or burns may need the use of a rapid infusion device to deliver large volumes of fluid within a short period.1
A massive infusion device can warm IV fluid or blood to room temperature, and then administer the fluid rapidly at rates up to 30,000 mL/hour. Remember that the device requires specialized IV tubing that expands under pressure.1
Equipment
IV fluids or blood products ▪ specialized infusion set ▪ replaceable filter or vent ▪ blood administration set ▪ IV pole ▪ gown and face protection ▪ gloves ▪ large-bore needle ▪ massive infusion device ▪ antiseptic solution ▪ male luer-lock cap ▪ blankets.
Implementation
Verify the doctor’s order.
Confirm that written informed consent was obtained and that the consent is in the patient’s medical record.3
Verify that baseline hemoglobin, hematocrit, electrolyte levels, and coagulation studies have been obtained to serve as a comparison and help guide fluid replacement.2
Confirm the patient’s identity using with at least two patient identifiers according to your facility’s policy.6
Make sure that the patient and his family understand the procedure. Answer any questions to evaluate their understanding of the information provided.
Insert an indwelling urinary catheter, as ordered, if the patient doesn’t already have one in place, to help monitor fluid resuscitation efforts. (See “Indwelling urinary catheter insertion,” page 377.)
Perform hand hygiene and put on sterile gloves and other personal protective equipment as needed.3,4,5
Make sure that the patient has patent IV access. If he doesn’t, insert an IV catheter to administer IV fluid and medications, as needed, until a central venous catheter can be inserted. (See “IV catheter insertion and removal,” page 421.)
Assist the doctor with central venous catheter or pulmonary artery catheter insertion to facilitate administration of large fluid volumes and to help monitor the patient’s fluid status. (See “Central venous access catheter,” page 133.)1
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