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Management of Gravity Intravenous Infusions in an Austere Environment Using the DripAssist Infusion Rate Monitor.

The US Army's 541st Forward Surgical Team (FST) deployed in support of Operation Inherent Resolve- Syria in 2017. Throughout the deployment the 541st FST provided surgical and anesthesia services to US, coalition, and partner forces in numerous austere environments. Following an enemy attack, the FST received multiple casualties and provided a total of 7 critical medication infusions to 3 patients without the aid of electronic-controlled intravenous (IV) infusion pumps or syringes for 10 hours while the wounded soldiers waited for evacuation to a higher level of care. The team administered propofol, norepinephrine, tranexamic acid, and ketamine by individual gravity infusions relying solely on counting drops. An infusion rate monitor (DripAssist, Shift Labs Inc) was used to assist in initial IV rate setup and maintenance. The medics and nurses of the 541st FST found that the infusion rate monitor improved the speed of setting the IV infusion rate, drop counting accuracy, and the team's ability to monitor the continuous delivery of gravity IV infusions.