Avoiding iatrogenic thrombo-embolism: the "KAPLIT" technique

In patients with traumatic injury of an upper limb it is often necessary to both secure intravenous (IV) access and record blood pressure noninvasively in the other upper limb. This may cause intermittent obstruction to the flow of IV fluids during cuff inflation. Also backflow of blood into the IV tubing when the cuff is inflated and the temporary stasis which occurs predisposes to clotting of blood in the IV tubing/catheter. Overenthusiastic efforts to push IV fluids without disconnection and flushing of IV line may pose a possible risk of embolizing the clotted blood thrombus into circulation. We describe a simple technique to prevent backflow of blood into the IV tubing when both intravenous fluid infusion and non-invasive blood pressure cuff are in the same limb. This may prevent clot formation and eliminate the risk of an iatrogenic thrombo-embolism.