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Thread: IV set ups and equipment

  1. #21
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    And I am VERY grateful for phlebotomists and nurses that do it for me in the little ones
    Good medicine in bad places

  2. #22
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    Baby steps

    The butterfly idea was from the Ditch Medicine DVD, and think those pics are with the 23G needle, the 750ml/hour rate was using a 21G I bought in my second order (and the largest I have). There is a, ah, tendon (?), that moves proximal/distal on the back of the hand when curling or extending the fingers that goes right over that favorite vein of mine, it's not a pleasant feeling when grasping / releasing things repeatedly with a metal needle is inserted under it. But I wanted something that might work on ages 4 to 94, and something I could practice on myself one-handed. Only done this on myself and one other young, healthy, willing adult victim/volunteer twice. Controlled situation, healthy adult with nice plumpy veins, taking my time, walking it though in my head, etc. Still trying to envision the problems of doing it under the pressure of real need, and the complications involved with an elderly or injured patient.
    Everything marked, everything 'membered. You wait, you'll see.

  3. #23
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    OK, so now what? Aside from treating dehydration (which can be done via other routes, with less investment in skill and equipment), what are you going to do with your IV skills?

    Dumping water (saline, D5, Ringers, whatever) into a bleeding person is not going to help. In fact it will usually make things worse - dilute the blood, dilute clotting factors, decrease the bloods ability to transport oxygen and carbon dioxide, usually lowers the core temperature. The whole Trauma Triad of Death in one bag.

    I'm not trying to put you down. Lets turn this into a teachable moment.
    Good medicine in bad places

  4. #24
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    And let's not go down the emergency field transfusion path...
    leave the gun... take the cannoli...

    In times of strength prepare for times of weakness...

  5. #25
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    Quote Originally Posted by HatetosayItoldyouso... View Post
    And let's not go down the emergency field transfusion path...
    LOL, no.
    Good medicine in bad places

  6. #26
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    Quote Originally Posted by HatetosayItoldyouso... View Post
    And let's not go down the emergency field transfusion path...
    Ok, but I have thought about it after reading some of the recent SOF Medic recommendations on fluid therapy for treating hemorrhagic shock in the field. The collection bags w/anticoagulents and IV blood product admin sets are available OTC, not very expensive, and can be stored for years on a shelf. See "A)" below, you're in charge, I'm just carrying some stuff you might need.


    Quote Originally Posted by Fidel. MD View Post
    OK, so now what? Aside from treating dehydration (which can be done via other routes, with less investment in skill and equipment), what are you going to do with your IV skills?

    Dumping water (saline, D5, Ringers, whatever) into a bleeding person is not going to help. In fact it will usually make things worse - dilute the blood, dilute clotting factors, decrease the bloods ability to transport oxygen and carbon dioxide, usually lowers the core temperature. The whole Trauma Triad of Death in one bag.

    I'm not trying to put you down. Lets turn this into a teachable moment.
    First, just so there's no confusion, this is SHTF use only. My reasoning for storing medicines and medical equipment I'm not trained to use is for (in order):

    A) There's a Dr available but (s)he lacks the necessary equipment/supplies, so we brought our own.
    B) I provide a distant Dr the information (s)he needs to make a diagnosis, and then (s)he tells me what to do over the phone/radio.
    C) I try to help without making things worse.

    For IV NS, my thinking is:

    -Can treat dehydration much more effectively and quickly, and bypassing the GI tract if they were suffering from gastroenteritis or had an abdominal injury. Can keep them hydrated whether they're sleeping, unconscious, sedated, or confused.

    -Preventing or treating shock, as from severe burns or hypovolemia (if we can stop the bleeding first). Parkland formula as the guide for burns, and try to raise their BP to about 70 in the event of extreme blood loss.

    -Warmed for treating hypothermia

    -Route for IV meds, assuming we knew what they needed and could buy, barter, beg, or steal the drugs.

    -With IV ethyl alcohol for sedation or management of severe pain.
    Everything marked, everything 'membered. You wait, you'll see.

  7. #27
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    leave the gun... take the cannoli...

    In times of strength prepare for times of weakness...

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