Quoted:
I got a shit ton of IV starter kits from my deployments
Now I just need bags of fluid.

Quoted:











The Op was talking about his wife, and tx his wife for dehydration.  If his wife is a 33lb kid, then there are other issues at play here.  Why in the flying fuck is it assumed that common sense has no play in first aid???  We talk all the time on here about double tapping an intruder and it is taken for granted that if the intruder is a 33 lb kid, you don't double tap them.  We talk about pulling security when TSHTF, but we don't assume that 33 lb kids will be pulling security.  We talk about hunting game, we don't assume the hunter is going to be a 33 lb kid, nor do we assume the game is going to be a 33lb kid.  WHY IN THE HELL DOES THE PATIENT ALWAYS HAVE TO BE ONE?????  AND WHY THE HELL DO WE ASSUME NO ONE IS SMART ENOUGH TO REALIZE THAT THE PATIENT IS A 33LB KID, BUT HAVE NO PROBLEM ASSUMING THAT SAME GODDAMN PERSON IS SMART ENOUGH TO FIGURE OUT THE DIFFERENCE BETWEEN A KID AND A DEER OR A KID AND AN INTRUDER?  HOLY FLYING FUCKBALLS BATMAN!  Just because the AMA says IV's are superinvolved ALS, doesn't mean with a little bit of training, your average person can't use them to treat dehydration on his wife.  Holy hell, we let Marines start IV's!





I get that with the introduction of major illness and the delivery of meds and extreme geriatric/pediatric situations, and with long term and repetitive use, or any combo there of, things get more complicated.  Schooling and experience are needed, and it would be patently impossible to use them without a couple of additional initials after your name.  But look at it this way, a hemostat is used for very delicate clamping of cardiac blood supply during pediatric heart surgery, which takes definite knowledge and training, but that doesn't take the use of hemostats away from your average person to get out a splinter.  





ETA:  another analogy:


   Guns.  Guns are dangerous.  They can cause death.  They can cause penetrating trauma.  They can poke out your eye.  Laying consistent suppressive fire to area and point targets at range is very difficult.  So, ONLY THE MILITARY SHOULD HAVE GUNS!  Leave it to the professionals before someone gets hurt.  What if it was a 33lb kid for crying out loud!





ETAA:  Looking at your screen name, its pretty obvious you are an anesthesiologist.  So, what you use an IV for is pretty complex.  Obviously, like I said earlier, there is no way it could be done without the extra letters behind your name, because med school means you are in fact better than the rest of us.  I guarantee you are better than your average CLS guy at needle sticks.  Because you went to med school.  *cough*


However, what you do is way different than 90% of situations that the could be used in.  
The single largest employer in the US (other than walmart) lets people start, utilize and dc IV's after a paltry 16 week training course, the first 8 weeks of which are an EMT certification.  IV training is a 3 week portion of the overall course, and that same three weeks also addresses intubation and basic surgery (in the field none the less!).  Once they graduate, they are capable of and pretty much required to start IV's and dc them with no continuation to a higher level of care just because an IV was utilized.  Oh yeah, did I mention that these were largely 18 y/o's doing this????   Then, this is the best part, that same 18 year old then goes out after just 16 weeks of medical training, trains other 18 year olds to start and administer IV's in a class that, on paper, is only 40 hours long, but in reality usually takes place o 3-4 4 hour days.  The best part?  I spent 8 years in this cycle, training CLS, running an aid station, running an ambulance platoon, Air evac, line medic, you name it, I did it, and not once did I see someone die or get a serious injury from an IV.  I saw some strange shit, people starting an IV the wrong direction, pulling out the catheter, not the needle, all kinds of crap, and no one died.  Sure, get a big enough group of ppl, and someone, somewhere will die.  Of course, someone somewhere dies eating a hot dog every year too.

Quoted:


The Op was talking about his wife, and tx his wife for dehydration.  If his wife is a 33lb kid, then there are other issues at play here.  Why in the flying fuck is it assumed that common sense has no play in first aid???  We talk all the time on here about double tapping an intruder and it is taken for granted that if the intruder is a 33 lb kid, you don't double tap them.  We talk about pulling security when TSHTF, but we don't assume that 33 lb kids will be pulling security.  We talk about hunting game, we don't assume the hunter is going to be a 33 lb kid, nor do we assume the game is going to be a 33lb kid.  WHY IN THE HELL DOES THE PATIENT ALWAYS HAVE TO BE ONE?????  AND WHY THE HELL DO WE ASSUME NO ONE IS SMART ENOUGH TO REALIZE THAT THE PATIENT IS A 33LB KID, BUT HAVE NO PROBLEM ASSUMING THAT SAME GODDAMN PERSON IS SMART ENOUGH TO FIGURE OUT THE DIFFERENCE BETWEEN A KID AND A DEER OR A KID AND AN INTRUDER?  HOLY FLYING FUCKBALLS BATMAN!  Just because the AMA says IV's are superinvolved ALS, doesn't mean with a little bit of training, your average person can't use them to treat dehydration on his wife.  Holy hell, we let Marines start IV's!

I get that with the introduction of major illness and the delivery of meds and extreme geriatric/pediatric situations, and with long term and repetitive use, or any combo there of, things get more complicated.  Schooling and experience are needed, and it would be patently impossible to use them without a couple of additional initials after your name.  But look at it this way, a hemostat is used for very delicate clamping of cardiac blood supply during pediatric heart surgery, which takes definite knowledge and training, but that doesn't take the use of hemostats away from your average person to get out a splinter.  

ETA:  another analogy:
   Guns.  Guns are dangerous.  They can cause death.  They can cause penetrating trauma.  They can poke out your eye.  Laying consistent suppressive fire to area and point targets at range is very difficult.  So, ONLY THE MILITARY SHOULD HAVE GUNS!  Leave it to the professionals before someone gets hurt.  What if it was a 33lb kid for crying out loud!

ETAA:  Looking at your screen name, its pretty obvious you are an anesthesiologist.  So, what you use an IV for is pretty complex.  Obviously, like I said earlier, there is no way it could be done without the extra letters behind your name, because med school means you are in fact better than the rest of us.  I guarantee you are better than your average CLS guy at needle sticks.  Because you went to med school.  *cough*
However, what you do is way different than 90% of situations that the could be used in.  


The single largest employer in the US (other than walmart) lets people start, utilize and dc IV's after a paltry 16 week training course, the first 8 weeks of which are an EMT certification.  IV training is a 3 week portion of the overall course, and that same three weeks also addresses intubation and basic surgery (in the field none the less!).  Once they graduate, they are capable of and pretty much required to start IV's and dc them with no continuation to a higher level of care just because an IV was utilized.  Oh yeah, did I mention that these were largely 18 y/o's doing this????   Then, this is the best part, that same 18 year old then goes out after just 16 weeks of medical training, trains other 18 year olds to start and administer IV's in a class that, on paper, is only 40 hours long, but in reality usually takes place o 3-4 4 hour days.  The best part?  I spent 8 years in this cycle, training CLS, running an aid station, running an ambulance platoon, Air evac, line medic, you name it, I did it, and not once did I see someone die or get a serious injury from an IV.  I saw some strange shit, people starting an IV the wrong direction, pulling out the catheter, not the needle, all kinds of crap, and no one died.  Sure, get a big enough group of ppl, and someone, somewhere will die.  Of course, someone somewhere dies eating a hot dog every year too.

Quoted:


And now no one messes with your toolkit :-)

I remember enema bags in the locally owned drug store when I was a kid, now reusable stuff is almost imposable to find through medical channels.  However google "Tyler Labs" if you don't mind purchasing from a sexual fetish shop.  Not cheap, and IIRC, the tubing was Latex (not an item for long term storage, so I replaced with poly tubing from the hardware store)

Disposable bags are available, but IIRC, they were pretty expensive for what looked like would only survive one time use.  Or just find some larger bulb syringes.

Not to to be dismissed is the threat of an enema making one do a better job of hydrating themselves.

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[Damn, I can remember getting enemas as a kid]

Quoted:


Suddenly things are becoming much clearer... Did they use Seafoam?  
 

Quoted:
While everyone is discussing people with GI fluid losses, presumable dehydration, potential contraction alkalosis and subsequent potassium loss, has anyone figured out how much potassium to replace? If you're going to stock D5W, or D5W * 1/2 NS, or LR, or 1/4NS?  Are you going to run 10mEq/mL of Potassium to make up for insensible losses throughout the day, or run an additional amount for someone who is severely potassium depleted?

Patch5 - you're throwing out medical advice to a hypothetical patient you haven't even laid eyes on?  Solid work.  Not saying the potential need for potassium replacement or any other issue is an absolute contraindication to running IV fluids, but there are a lot of possibilities to worry about.  Starting an IV is simple enough that a monkey can do it when you're en route to a hospital where the patient can be formally assessed.  Running IVs on an unknown patient because someone is too lazy to take small sips orally is borderline reckless.

Quoted:


There is potassium in LR.  

Kind of hard to put eyes on a hypothetical pt isn't it?  

Sorry guys.  I come from an environment where IV's weren't critical care requiring MD's, RN's ect, to oversee their use (Military).  I've started literally thousands in both emergent and non emergent situations.  Kept it simple, NS or LR.  Watch the pt.  Shrug.  I guess that makes me a mass murderer, because surely all of my patients must have died from their IV's.  I'll leave this thread to the people who charge $200 an hour for the privilege of their knowledge.  

Quoted:
K+ is 1.7

Quoted:
trimmed.

The concern is PATCH5 that IV fluids are a very serious and very complex topic that is difficult to explain in a thread. I have a textbook regarding electrolytes and fluid management alone in addition to a whole textbook dedicated to infusion therapy, not to mention a med surg book and advanced med surg book that teach one to identify problems such as fluid overload. To simply dismiss IV fluids as a benign treatment shows profound ignorance of the seriousness of the matter. There is a reason why outside of the military only certain licensed individuals may administer and monitor fluids.

There may be set protocol in the military to administer certain IV fluids under certain conditions and in certain manners but mistaking protocol for simplicity is dangerous. I assume you are a medic, I would hope you would realize that the main role of the medic in the field is to stabilize and keep the patient alive long enough for that individual to be transferred out and receive real treatment, no offense. Most of the scenarios here in SHTF do not allow for eventual evaluation and treatment by healthcare professionals.

One has to understand the difference between colloids, crystalloids, and volume expanders and what role each has to play. One would also need to understand the dynamics of hydration and electrolytes, and the importance of IV fluids. Take someone who is very dehydrated with a very high Na level and you rehydrate quickly with NS thinking that they need all this fluid quickly and bingo…one dead patient.

IV fluids are not simple nor benign…messing around with electrolytes without a firm grasp upon the concept is a great way to have a dead person.  

All this being said I would however not be opposed to developing a protocol for rehydration that the Survival forum can utilize under specific circumstances. I would also like to point out that in nearly every single large city there should be at least one or two IV classes, usually given by a community college or pharmacy that is geared towards CNAs, LPNs, and RN refreshers. These classes will teach you basic PIV administration and assessment.

Quoted:


Ok, so I lied about leaving this thread to the professionals
I think that would be a spectacular idea personally.  Despite all my bluster earlier (largely arguing the opposing POV to the medical society's take on basic fluid re-hydration/resuscitation ), I haven't started an IV since 2007, shortly after I left the .mil.  If nothing else, a protocol developed for basic fluid replacement (maybe IV and non IV methodology both?) would be very welcome in my "Its the end of the world and now we are all fucked" binder.  
I still stand by everything I have said, but, like I've freely admitted dozens of times on here, take my advice and opinion for what they are worth because there is a decent chance they are worth what you paid for them.