Your casualty has severe wounds to both upper extremities. They have absent radial pulses. What is the appropriate site and method to give them fluids?

In cases of severe trauma with significant wounds to both upper extremities and absent radial pulses, it is crucial to quickly establish vascular access for fluid resuscitation. Using the manubrium for fluid administration is an effective choice in this scenario. The manubrium allows for access to the central venous system through a method known as the intraosseous (IO) route, specifically when utilizing devices designed for this purpose.

The FAST 1 device is specifically intended for fast and efficient access in emergency situations, particularly when traditional IV access is compromised or difficult due to severe injuries. Since the upper extremities are wounded and may not provide reliable vascular access, the manubrium serves as a reliable alternative to facilitate urgent fluid delivery directly into the central circulation, ensuring that the patient receives the necessary fluids for stabilization.

Other options may not provide the same efficacy or appropriateness in this situation. The subclavian and femoral sites have their considerations for use, but immediate access through the manubrium in a trauma context can be significantly more advantageous. Therefore, the choice of the manubrium with the FAST 1 method is well-suited for addressing the urgent needs of a patient experiencing severe trauma with compromised vascular access.