Pressure dynamics of various irrigation techniques commonly used in the emergency department.
OBJECTIVE
To evaluate the pressure dynamics of common irrigation techniques used in the treatment of traumatic wounds.


METHODS
Matched experimental trial.


METHODS
Ten male volunteers.


METHODS
Pressure curves were obtained while performing manual irrigation with 250-mL boluses of normal saline with 19-gauge needles on 35-mL syringes, 19-gauge needles on 65-mL syringes, IV bags pierced with 19-gauge needles, and plastic bottles pierced with 19-gauge needles. Measurements also were obtained using an IV bag with tubing attached to either a 19-gauge or 16-gauge needle within a pressure cuff inflated to 400 mm Hg.


RESULTS
Median peak pressures were 35 lb/in.2 (psi)(range, 25 to 40 psi) and 27.5 psi (range, 15 to 40 psi) using a 35-mL syringe and a 65-mL syringe, respectively. Median peak pressures with the IV bag and plastic bottle were 4 psi (range, 2 to 5.5 psi) and 2.3 psi (range, 1.2 to 4.5 psi), respectively. The IV bag in a pressure cuff generated pressures of 6 to 10 psi and 4 to 6 psi using 19-gauge and 16-gauge needles, respectively.


CONCLUSIONS
Both 35-mL and 65-mL syringes with a 19-gauge needle are effective in performing high-pressure irrigation in the range of 25 to 35 psi. The use of IV bags and plastic bottles should be discouraged when high-pressure irrigation is required.
Singer
A J
AJ
Department of Emergency Medicine, State University of New York at Stony Brook.
Hollander
J E
JE
Subramanian
S
S
Malhotra
A K
AK
Villez
P A
PA
D000328:Adult; D004635:Emergency Medicine / Q000295:instrumentation* / Q000379:methods; D004636:Emergency Service, Hospital; D006801:Humans; D008297:Male; D009339:Needles; D011312:Pressure; D013594:Syringes; D007507:Therapeutic Irrigation / Q000295:instrumentation* / Q000379:methods; D014947:Wounds and Injuries / Q000628:therapy*