LETTERS TO THE EDITOR: Letters & Announcements
To the Editor:
Injecting manually with a syringe has been used to start rapid infusion for sudden massive bleeding. We present a useful method using a three-way stopcock with two no-return valves for rapid infusion. In this method, we connected two no-return valves (JMS, Hiroshima, Japan) to both sides of a three-way stopcock (JMS) (Fig. 1). Pumping the cylinder of the syringe up and down can generate appropriate volume flow to one side without circling the cock of the three-way stopcock. We compared the flow rate using this system to that of one using a three-way stopcock without the no-return valves. Using a volunteer, we measured the volume of the water that could be infused within 20 seconds using either the system (the nonreturn group) or a three-way stopcock without the no-return valves (the three-way group). In the three-way group, 54.8 ± 3.0 ml of water was infused per 20 seconds (n = 8). In the nonreturn group, about two times the volume of water was infused (98.2 ± 6.0 ml/20sec, n = 9, p<0.001 versus the three-way group, paired t-test). We have already used the system for 3 months; in that time, there have been no complications (such as infusion of air or hemolysis). The rapid infusion system using a three-way stopcock with two no-return valves should be considered for rapid infusion for massive bleeding.
Masayuki Ozaki, MD
Kouichiro Minami, MD, PhD
Akio Shigematsu, MD, PhD