AS9.1-4 | Fluids, Blood Products and Vascular Access — Glossary

Intravascular haemolysis caused by ABO-incompatible transfusion; pre-formed IgM antibodies activate complement causing haemoglobinuria, DIC, renal failure, and shock — the most dangerous acute transfusion reaction

Crystalloid solution (e.g. Hartmann's / Ringer's lactate, Plasmalyte) with an electrolyte composition and pH close to plasma, avoiding the hyperchloraemic acidosis caused by large volumes of 0.9% saline

Bloodstream infection attributable to an intravascular catheter, diagnosed when the same organism is cultured from the catheter tip and peripheral blood without another source

The point where the superior vena cava meets the right atrium; the optimal CVC tip position — visible on chest X-ray at the level of the carina

A catheter whose tip lies in a large central vein (SVC, IVC, or brachiocephalic vein), used for haemodynamic monitoring, vasopressor infusion, and multiple simultaneous drug infusions

The intravascular pressure measured in the superior vena cava or right atrium, reflecting right heart filling pressure; normal 5–12 cmH₂O (3–8 mmHg)

IV fluid containing large molecules (albumin, starch, gelatin) that exert oncotic pressure and preferentially remain intravascular, providing greater volume expansion per litre than crystalloids

Cold-insoluble fraction of FFP containing concentrated fibrinogen, Factor VIII, vWF, Factor XIII, and fibronectin; primary indication is fibrinogen deficiency (<1.5 g/L) with active bleeding

IV fluid containing small molecules (electrolytes, glucose) that distribute freely across capillary membranes; approximately 25% remains intravascular at 30 minutes after infusion of an isotonic crystalloid

Haemostatic resuscitation strategy in massive haemorrhage using high PRBC:FFP:platelet ratios (typically 1:1:1) to maintain coagulation factor concentration while limiting crystalloid, preventing dilutional coagulopathy

Structured, effortful repetition of specific skill components with immediate feedback — the pedagogical model underpinning simulation-based procedural training

A workplace-based assessment tool in which a trained assessor observes and scores a trainee performing a specific procedural skill, providing immediate structured feedback

Leakage of IV fluid or drugs into perivascular tissue, causing swelling, pain, and — with caustic agents — tissue necrosis

The most common transfusion reaction; fever and rigors caused by recipient antibodies against donor leukocyte antigens or accumulated cytokines in stored blood; usually self-limiting; manage with antipyretics

The deep vein of the thigh lying immediately medial to the femoral artery at the mid-inguinal point; used for emergency vascular access when thoracic sites are contraindicated

Plasma coagulation protein (normal 2–4 g/L) converted to fibrin by thrombin, forming the structural matrix of a blood clot; the first clotting factor to reach critically low levels in massive haemorrhage

The first appearance of blood in the cannula hub or syringe confirming that the needle tip has entered the vascular lumen

Plasma separated from whole blood and frozen within 8 hours, containing all clotting factors including labile V and VIII; used for coagulopathy with active bleeding (INR >1.5) and massive transfusion

A dynamic approach to perioperative fluid administration using haemodynamic parameters (SVV, PPV, oesophageal Doppler stroke volume) to identify fluid-responsive patients and restrict fluid to those who will benefit

A flexible wire with a soft J-tip used in the Seldinger technique to exchange an access needle for a catheter; must be controlled by the operator at all times to prevent embolisation

Metabolic acidosis caused by excess chloride load (from 0.9% saline) suppressing renal bicarbonate reabsorption and reducing renal blood flow; associated with increased AKI risk in large-volume resuscitation

The large venous trunk draining the brain and face, descending in the carotid sheath lateral to the common carotid artery; the most common site for central venous catheterisation in anaesthesia

Full aseptic precautions during CVC insertion: operator cap, mask, sterile gown and gloves, and a full-body sterile drape over the patient — mandated by CRBSI-prevention bundles

The calculated volume of blood a patient can lose before requiring transfusion: MABL = EBV × (starting Hct − minimum acceptable Hct) ÷ average Hct; guides the decision threshold for blood product use

Concentrated red cell preparation (Hct ~60–70%) derived by removing plasma and platelets from whole blood; one unit raises Hb ~1 g/dL; standard transfusion trigger Hb <7 g/dL in stable patients

Inflammation of a peripheral vein, manifesting as erythema, warmth, swelling, and tenderness along the vessel; graded 0–4 using the VIP (Visual Infusion Phlebitis) score

Air in the pleural cavity causing lung collapse; a recognised complication of subclavian and internal jugular vein catheterisation due to the proximity of the pleural apex

The percentage variation in arterial pulse pressure across the respiratory cycle during mechanical ventilation; like SVV, a dynamic predictor of fluid responsiveness; PPV >12% predicts positive response to fluid bolus

Wire-guided catheter insertion: a hollow access needle enters the vessel, a flexible guidewire is threaded through the needle, the needle is removed, and a catheter is advanced over the wire into the vessel

The cyclic variation in left ventricular stroke volume during mechanical ventilation, expressed as a percentage; SVV >12–15% indicates likely fluid responsiveness in ventilated patients with regular rhythm

The continuation of the axillary vein, passing beneath the clavicle anterior to the subclavian artery; preferred site for long-term CVCs due to lowest infection rate but highest pneumothorax risk

Hydrostatic pulmonary oedema from excessive transfusion volume; distinguished from TRALI by elevated PAWP, raised BNP, and response to diuretics; more common in elderly patients with cardiac dysfunction

Historically, a non-functional fluid compartment thought to accumulate fluid during major surgery; modern evidence suggests this reflects capillary leak from surgical inflammation rather than a distinct anatomical space

A tapered stiff plastic device passed over the guidewire to enlarge the tract through skin and subcutaneous tissue before catheter insertion

Non-cardiogenic pulmonary oedema occurring within 6 hours of transfusion, caused by donor anti-HLA/anti-neutrophil antibodies activating recipient pulmonary neutrophils; leading cause of transfusion-related mortality

A 0–4 grading scale for peripheral IV site inflammation based on pain, erythema, swelling, palpable venous cord, and purulent discharge