I had a fantasy that with a large bore catheter and the Belmont Rapid Infuser, I would be able to transfuse blood products at a rate of 700 ml/minute, keeping the bleeding patient alive while the surgeons found and stopped the bleeding.
The reality is that although I was able to do this once or twice, the majority of my experiences with the Belmont Rapid Infuser has been that I spend too much time distracted by the Belmont’s alarms and not enough time taking care of the patient.
June 4, 2013:
Actually, there was a problem with the Rapid Infuser that has been rectified by the company.
The device now works as advertised and it is life saving.
The fantasy and reality are congruent.
Click on this link to view the Belmont instructional video:
Click on this link to view the Belmont set up PDF:
I have had problems loading the Belmont Rapid Infuser. The represntative came to our institution and gave me tips on how to properly load the cassette and prime the infuser.
This is what I gleaned:
Here is an interesting link on the death of a liver transplant donor at the Lahey Clinic that was reported by CNN.
The reports cites three factors as to the probable cause of death.
- Possible abnormal preop cardiac status (abnormal EKG).
- Failure to use the Belmont Transfuser, which was available.
- Failure to activate the Massive Transfusion Protocol.
What we as anesthesiologists need to do is insure that we can transfuse life saving fluids/blood/coagulation factors as rapidly as possible while surgeons work to stop bleeding. THIS IS THE CHALLENGE.
Anesthesiologists need to practice/drill with:
- Obtaining large bore IV access (RIC, Arrow Rapid Infusion Catheter).
- Practice with quickly setting up and using the Belmont Rapid Infuser.
- Ironing out the kinks of obtaining blood products from the blood bank when the Massive Transfusion Protocol is activated.