• Evan T Cole, Greg Harvey, Gary Foster, Lehana Thabane, and Melissa J Parker.
• Department of Pediatrics, McMaster Children's Hospital and McMaster University, Hamilton, Ontario, Canada.
• BMJ Open. 2013 Jan 1; 3 (3).

IntroductionPaediatric shock is a life-threatening condition with many possible causes and a global impact. Current resuscitation guidelines require rapid fluid administration as a cornerstone of paediatric shock management. However, little evidence is available to inform clinicians how to most effectively perform rapid fluid administration where this is clinically required, resulting in suboptimal knowledge translation of current resuscitation guidelines into clinical practice.ObjectivesThis study aims to determine which of the two commonly used techniques for paediatric fluid resuscitation (disconnect-reconnect technique and push-pull technique) yields a higher fluid administration rate in a simulated clinical scenario. Secondary objectives include determination of catheter dislodgement rates, subjective and objective measures of provider fatiguability and descriptive information regarding any technical issues encountered with performance of each method under the study.Methods And AnalysisThis study will utilise a randomised crossover trial design. Participants will include consenting healthcare providers from McMaster Children's Hospital. Each participant will administer 900 ml (60 ml/kg) of normal saline to a simulated 15 kg infant as quickly as possible on two separate occasions using the manual fluid administration techniques under the study. The primary outcome, rate of fluid administration, will be evaluated using a paired two-tailed Student t test.Ethics And DisseminationThis protocol has been approved by the Hamilton Health Sciences Research Ethics Board.ResultsThese will be published in a peer-reviewed scientific journal and presented at one or more scientific conferences.Protocol RegistrationProtocol Registered on ClinicalTrials.gov NCT01774214.

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