UMEM Educational Pearls

Flow rates are, in theory, determined by Poiseuille’s Law, which states that the flow rate depends on fluid viscosity, pipe length, and the pressure difference between the ends of the pipe .  

Of course we won’t be calculating this during a resuscitation! Nor would it be useful if we did: the equation assumes laminar flow, whereas turbulent flow is more likely.  Nor is it practical to look up the viscosity of crystalloid/blood/plasma, which also dramatically impacts flow rates.   

Instead, remember this equation:  Larger + shorter = faster  

And keep in mind the following:

  1. Excess IV tubing can decrease your flow rate no matter the size of your catheter
  2. All connectors (J-loops, needlefree connectors, etc) will dramatically decrease your flow rate.  Do not add to the catheter if your goal is faster flow!

In practice, our friends in Australia actually put common catheters to the test, and provided these helpful results:

Or, as a picture:

Note, these flow rates were achieved using crystalloid.  Blood will be slower due to higher viscosity.

References

  1. Poiseuille’s Law | Harvard Natural Sciences Lecture Demonstrations. n.d. URL: https://sciencedemonstrations.fas.harvard.edu/presentations/poiseuilles-law (Accessed 9 April 2025).
  2. Reddick AD, Ronald J, Morrison WG. Intravenous fluid resuscitation: was Poiseuille right? Emerg Med J 2011;28:201–2. https://doi.org/10.1136/emj.2009.083485.
  3. Pixelstorm. Large bore IV access showdown – Round 2. ETM Course 2016. URL: https://etmcourse.com/large-bore-iv-access-showdown-round-2/ (Accessed 9 April 2025).
  4. Nickson C. Fluid administration device flow rates. Life in the Fast Lane • LITFL 2019. URL: https://litfl.com/fluid-administration-device-flow-rates/ (Accessed 9 April 2025).
  5. Pixelstorm. Large Bore IV Access Showdown: Do you know which IV cannula can deliver fluid to your patient the fastest? ETM Course 2015. URL: https://etmcourse.com/large-bore-iv-access-showdown/ (Accessed 9 April 2025).