An “Old Trick” but a Potential Problem

You have anesthetized an 18-mo-old child with facial deformity requiring surgical correction. He is otherwise healthy and is classified as an American Society of Anesthesiologists physical status 1. Unfortunately, there is more blood loss than anticipated, and the blood pressure is beginning to drop. While awaiting blood from the blood bank, you start infusing albumin 5% (250 ml bottle), but it is going very slowly through your 22-gauge IV in the hand. You have the following options: stop the surgery and get better IV access or aspirate the albumin into a 20-ml syringe from an in-line three-way stopcock, and then turn the stopcock and inject the albumin rapidly into the patient.