Sir,

In few cases during perioperative period, the anesthesiologist has to transfuse fluid rapidly to restore the intravascular volume and save the patient from impending hypovolumic shock. Rapid infusion of fluid can ideally be achieved with either a pressure bag or manually squeezing the fluid bottle. But in situations where pressure bag is not available (or none functioning) and trained assistant is not there to squeeze the bottle manually, we used the manual sphygmomanometer cuff as a replacement to pressure bag.

The sphygmomanometer cuff was detached from the mercury manometer and wrapped snuggly to the hanging fluid bottle connected to the patient through vascular cannula. The tubing of the cuff that was attached to the sphygmomanometer was blocked with an artery clamp and the second tubing with inflating bulb was squeezed to raise the pressure inside the cuff. We found this as a very effective method of infusing fluid rapidly into the vascular system through a proper sized vascular cannula and restoring the haemodynamic stability in severe hypovolumic shock

I would also like to mention that, the same principle can be applied to flush the arterial line through a pressurized heparinised saline flush bottle attached to the arterial transducer.

Finally we advocate, in case of non availability of pressure bag, the manual sphygmomanometer cuff can be used successfully and is accost effective alternative.

Yours truly

Dr.Aloka Samantaray, M.D., PDCC Assistant Professor Department of Anesthesiology and Critical Care S.V.Institute of Medical Sciences (SVIMS) Tirupati, AP, INDIA E mail alokorissa@yahoo.co.in