Posted: 8/2/2010 10:55:04 AM EDT
| Any non-traditional sources for IV bags? Obviously there aren't IV kits for fish. |
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Google rectal hydration. [Let the immature pervs begin posting...] I wouldn't use one as an IV bag.  Anyway, simpler and safer for rehydration, and reusable.
But for the real thing, google intravenous fluids. I've never had too much trouble buying them. I supose if you live in NY state, they are actually illegal to sell without a certificate of need (not the IV bag, but the catheter.) But this is one thing you will never learn to do by reading. You either need a practice dummy, or just a dummy. Or maybe a heroin addict who needs a few bucks. Even then, it takes a lot of experience to do an overweight, dehydrated, black man with low blood pressure. If you know a RN or EMT whose good at them, get some lessons. Most nurses and MD's aren't that good unless thye work in the emergency room, do a lot of lab work, or are in anestheslogy. OTOH, some 20yo nurses fresh out of medical school can't see what the big deal is and get stuck doing the difficult patients. But outside the ER or OR, paramedics have the best skills. EMT-Is do IVs, but rarely is it a critical skil, so someone who is weak isn't forced to get better. |
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Google rectal hydration. [Let the immature pervs begin posting...] He's saying in most situations where you might want an IV, rectal rehydration might be a better choice. Now if you're trying to replace blood volume lost to trauma that isn't going to work. If you're in that territory you need a whole lot more training and skill anyway, and probably have a hookup for the real thing anyway. |
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Quoted: Quoted: Google rectal hydration. [Let the immature pervs begin posting...] I wouldn't use one as an IV bag. Anyway, simpler and safer for rehydration, and reusable.But for the real thing, google intravenous fluids. I've never had too much trouble buying them. I supose if you live in NY state, they are actually illegal to sell without a certificate of need (not the IV bag, but the catheter.) But this is one thing you will never learn to do by reading. You either need a practice dummy, or just a dummy. Or maybe a heroin addict who needs a few bucks. Even then, it takes a lot of experience to do an overweight, dehydrated, black man with low blood pressure. If you know a RN or EMT whose good at them, get some lessons. Most nurses and MD's aren't that good unless thye work in the emergency room, do a lot of lab work, or are in anestheslogy. OTOH, some 20yo nurses fresh out of medical school can't see what the big deal is and get stuck doing the difficult patients. But outside the ER or OR, paramedics have the best skills. EMT-Is do IVs, but rarely is it a critical skil, so someone who is weak isn't forced to get better. I'm actually better at starting IVs than my wife - whose a trauma nurse / conscious sedation nurse (RN) and a national registry paramedic. One of the side affects of having been in 5th SFG(A) (desert orientation = hydration emphasis) and making medical cross training a priority when you have a direct action mission (trauma focused). At Walter Reed I talked the anesthesiologist resident through starting my IV before my prostate cancer surgery (true story). |
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Quoted: Quoted: What about IV bags (kits) for dogs, cats, horses, cattle, etc.? Any non-traditional sources for IV bags? Obviously there aren't IV kits for fish.  Are you thinking hydration or IV antibiotics?I was thinking about trauma and hydration. Like if your fish had a sucking chest wound because looter fish tried to take his little submerged castle during a period where animal hospital was out of commission and the fish paramedics went home to take care of their own little submerged castles and you had to replace blood loss volume. Or my dog got heat stroke because ... |
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What about IV bags (kits) for dogs, cats, horses, cattle, etc.? Any non-traditional sources for IV bags? Obviously there aren't IV kits for fish. Are you thinking hydration or IV antibiotics?
I was thinking about trauma and hydration. Like if your fish had a sucking chest wound because looter fish tried to take his little submerged castle during a period where animal hospital was out of commission and the fish paramedics went home to take care of their own little submerged castles and you had to replace blood loss volume. Or my dog got heat stroke because ... without a blood transfusion adding NS to a PT with that much volume lose your doing nothing but wasting your IV supplies. NS does not replace blood because it can not carry O2. yeah, your adding volume but thats it. without the cells your PT is still going to die. |
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Quoted: Quoted: Quoted: Quoted: What about IV bags (kits) for dogs, cats, horses, cattle, etc.? Any non-traditional sources for IV bags? Obviously there aren't IV kits for fish. Are you thinking hydration or IV antibiotics?I was thinking about trauma and hydration. Like if your fish had a sucking chest wound because looter fish tried to take his little submerged castle during a period where animal hospital was out of commission and the fish paramedics went home to take care of their own little submerged castles and you had to replace blood loss volume. Or my dog got heat stroke because ... without a blood transfusion adding NS to a PT with that much volume lose your doing nothing but wasting your IV supplies. NS does not replace blood because it can not carry O2. yeah, your adding volume but thats it. without the cells your PT is still going to die. Actually volume replacement is indicated in trauma (I would use Ringer's Lactate vice NS in treating a gunshot trauma in fish but that's another discussion). There is a level of blood loss below which you need to use transfusion, but above that (assuming you stop the bleeding so you never get to that point) blood volume expanders / oxygen therapeutics are used. If its a question of whether to stand helplessly and watch your "fish" die or do something, I vote for do something. NS or D5W for rehydration or drug delivery. My aquarium's situation is different than most. My wife is RN with a trauma background both as a RN and as a paramedic, my youngest is a Combat Life Saver with two tours in Iraq and I had extensive medical crosstraining in SF. |
Tractor supply has IV kits. Not sure if they are sterile. I believe I saw IV solution there as well. Again, not sure of what it is, because I don't have any training with that type of treatment. In first responder training they said we couldn't legally stick anybody  . You might try the website.
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What about IV bags (kits) for dogs, cats, horses, cattle, etc.? Any non-traditional sources for IV bags? Obviously there aren't IV kits for fish. Are you thinking hydration or IV antibiotics?
I was thinking about trauma and hydration. Like if your fish had a sucking chest wound because looter fish tried to take his little submerged castle during a period where animal hospital was out of commission and the fish paramedics went home to take care of their own little submerged castles and you had to replace blood loss volume. Or my dog got heat stroke because ... without a blood transfusion adding NS to a PT with that much volume lose your doing nothing but wasting your IV supplies. NS does not replace blood because it can not carry O2. yeah, your adding volume but thats it. without the cells your PT is still going to die. Actually volume replacement is indicated in trauma (I would use Ringer's Lactate vice NS in treating a gunshot trauma in fish but that's another discussion). There is a level of blood loss below which you need to use transfusion, but above that (assuming you stop the bleeding so you never get to that point) blood volume expanders / oxygen therapeutics are used. If its a question of whether to stand helplessly and watch your "fish" die or do something, I vote for do something. NS or D5W for rehydration or drug delivery. My aquarium's situation is different than most. My wife is RN with a trauma background both as a RN and as a paramedic, my youngest is a Combat Life Saver with two tours in Iraq and I had extensive medical crosstraining in SF. That is correct. You would want to use Ringers. However, even with bone breaks and other various traumas, normal saline will do wonders to treat shock and keep the BP high enough. An IV with NS is indicated for a ton of different injuries. |
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without a blood transfusion adding NS to a PT with that much volume lose your doing nothing but wasting your IV supplies. NS does not replace blood because it can not carry O2. yeah, your adding volume but thats it. without the cells your PT is still going to die. That seems logical, but Med school and EMT school teach that you will die from low blood pressure before you die from loss of RBCs. If you can survive long enough you will replace the RBC. What has fell out of favor is pouring on the fluids which reduces clotting time (PTT). With all of the recent experience DOD has gotten even more agressive on pushing fluids to trauma pts. For some this may be a stopgap measure until whole blood is available, but there are plenty who stay in the window of needing the IV, but not needing blood. And not everyone who recieved blood would have died without it (The same can be said for IVs, of course) I really don't stock IVs for trauma- I don't think we could manage trauma severe enough to need them- And with the current knowledge of tourniquets, I don't see most extremity trauma causing that kind of blood loss. |
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What about IV bags (kits) for dogs, cats, horses, cattle, etc.? Any non-traditional sources for IV bags? Obviously there aren't IV kits for fish. Are you thinking hydration or IV antibiotics?
I was thinking about trauma and hydration. Like if your fish had a sucking chest wound because looter fish tried to take his little submerged castle during a period where animal hospital was out of commission and the fish paramedics went home to take care of their own little submerged castles and you had to replace blood loss volume. Or my dog got heat stroke because ... I love how this thread is developing...
Just to be clear, your fish can have a sucking chest wound and not need IV hydration... having said that, in a situation where there is sufficient blood loss to produce shock, you need to stop the bleeding and then volume expand the fish with any IV solution you have on hand... although, this fish needs real medical care - what you are doing is just "first aid"... advanced first aid I grant you but first aid nonetheless... you need a plan for what to do after you pour in a few liters of fluid. In addition, not many folks have the training to correctly and effectively use IV fluids but If you do, good for you - I am sure your fish appreciate your dedication and caring...
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Google rectal hydration. [Let the immature pervs begin posting...] I wouldn't use one as an IV bag. Anyway, simpler and safer for rehydration, and reusable.
But for the real thing, google intravenous fluids. I've never had too much trouble buying them. I supose if you live in NY state, they are actually illegal to sell without a certificate of need (not the IV bag, but the catheter.) But this is one thing you will never learn to do by reading. You either need a practice dummy, or just a dummy. Or maybe a heroin addict who needs a few bucks. Even then, it takes a lot of experience to do an overweight, dehydrated, black man with low blood pressure. If you know a RN or EMT whose good at them, get some lessons. Most nurses and MD's aren't that good unless thye work in the emergency room, do a lot of lab work, or are in anestheslogy. OTOH, some 20yo nurses fresh out of medical school can't see what the big deal is and get stuck doing the difficult patients. But outside the ER or OR, paramedics have the best skills. EMT-Is do IVs, but rarely is it a critical skil, so someone who is weak isn't forced to get better. So much wrong, even ignoring the spelling......
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Rule of thumb on isotonic IV fluid administration (NS, ringers lactate, normosol R, etc.) during acute blood loss from trauma is 2:1. For every 1 cc of blood loss, you should replace it with 2 cc of IVF to sustain intravascular volume, and ultimately sustain blood pressure. A healthy person can tolerate a pretty damn low hemoglobin (blood count) and still survive. The Jehovah's Witness population will refuse to receive blood, and have subsequently given us some examples of just how low a blood count a person can have and still survive without permanent damage. Generally speaking though any person with heart disease, vascular disease, severe lung disease, etc. will not do well with a hemoglobin below 10mg/dl (unless they are chronically anemic - which is a different animal altogether from acute blood loss). Bottom line: If you don't have blood to transfuse you should use IVF as a replacement until you can get the patient to the replacement blood (or get the replacement blood to the patient). 2:1 IVF for acute blood loss. Hold pressure, stop bleeding by any means necessary. |
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Rule of thumb on isotonic IV fluid administration (NS, ringers lactate, normosol R, etc.) during acute blood loss from trauma is 2:1. For every 1 cc of blood loss, you should replace it with 2 cc of IVF to sustain intravascular volume, and ultimately sustain blood pressure. A healthy person can tolerate a pretty damn low hemoglobin (blood count) and still survive. The Jehovah's Witness population will refuse to receive blood, and have subsequently given us some examples of just how low a blood count a person can have and still survive without permanent damage. Generally speaking though any person with heart disease, vascular disease, severe lung disease, etc. will not do well with a hemoglobin below 10mg/dl (unless they are chronically anemic - which is a different animal altogether from acute blood loss). Bottom line: If you don't have blood to transfuse you should use IVF as a replacement until you can get the patient to the replacement blood (or get the replacement blood to the patient). 2:1 IVF for acute blood loss. Hold pressure, stop bleeding by any means necessary.
That's really great advice. There's some math involved that he didn't add, than can really work for or against someone in a trauma setting. If you're giving someone a NS (Normal Saline) IV for Hypovolemia (Blood loss / Shock from blood loss) only 20% of that IV solution will maintain in the blood stream, the rest will disperse into the tissue over time. You have an 80% volume loss for every cc you put into a patient, however, attempting to put in large volumes of NS can also lead to circulatory overload or just plain hemodilution which is fatal. It is NOT recommended you use NS for replacement of lost blood for the above stated reasons. As someone else stated above, their are way easier methods for rehydration than putting a line in someone. OP: If you're looking for a trauma fix, IVs sound great, but they are a small tool in a huge toolbox. If you were to give *HEXTEND* to an individual who needed it, he's probably so far gone that you're gonna need a doctor sooner than you can get one. If you needed to give NS to someone, chances are you're close enough he can wait for the medics. If you really want some life saving intervention from trauma, find a medic who doesn't mind showing you how CAT tourniquets work, keep 6 of them in your bag, and keep 1 or 2 to practice with. **ETA: I just noticed, you're MIL and got the crossed arrows... Why not contact a 68J ... and.. ask for some? I'm sure they wouldn't mind handing you a dozen or so. |
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Quoted: Quoted: Rule of thumb on isotonic IV fluid administration (NS, ringers lactate, normosol R, etc.) during acute blood loss from trauma is 2:1. For every 1 cc of blood loss, you should replace it with 2 cc of IVF to sustain intravascular volume, and ultimately sustain blood pressure. A healthy person can tolerate a pretty damn low hemoglobin (blood count) and still survive. The Jehovah's Witness population will refuse to receive blood, and have subsequently given us some examples of just how low a blood count a person can have and still survive without permanent damage. Generally speaking though any person with heart disease, vascular disease, severe lung disease, etc. will not do well with a hemoglobin below 10mg/dl (unless they are chronically anemic - which is a different animal altogether from acute blood loss). Bottom line: If you don't have blood to transfuse you should use IVF as a replacement until you can get the patient to the replacement blood (or get the replacement blood to the patient). 2:1 IVF for acute blood loss. Hold pressure, stop bleeding by any means necessary. That's really great advice. There's some math involved that he didn't add, than can really work for or against someone in a trauma setting. If you're giving someone a NS (Normal Saline) IV for Hypovolemia (Blood loss / Shock from blood loss) only 20% of that IV solution will maintain in the blood stream, the rest will disperse into the tissue over time. You have an 80% volume loss for every cc you put into a patient, however, attempting to put in large volumes of NS can also lead to circulatory overload or just plain hemodilution which is fatal. It is NOT recommended you use NS for replacement of lost blood for the above stated reasons. As someone else stated above, their are way easier methods for rehydration than putting a line in someone. OP: If you're looking for a trauma fix, IVs sound great, but they are a small tool in a huge toolbox. If you were to give *HEXTEND* to an individual who needed it, he's probably so far gone that you're gonna need a doctor sooner than you can get one. If you needed to give NS to someone, chances are you're close enough he can wait for the medics. If you really want some life saving intervention from trauma, find a medic who doesn't mind showing you how CAT tourniquets work, keep 6 of them in your bag, and keep 1 or 2 to practice with. It's good you added the warning about over doing IVF. You can over do IVF and do more harm than good. Maintaining the colloid osmotic pressure with hespan, hextend, albumin, or the like will indeed help minimize fluid extravasation and help keep fluid where it will do the most good. But ultimately stopping blood loss and replacing the lost blood with products will be what saves the life of the victim. With respect to fluid blousing bolusing an acutely dehydrated person that's otherwise healthy, I would advise an IVF bolus of up to 20 cc per kilogram of body weight on an young adult, adult, and healthy senior. For example a person that weighs 175 pounds = 80 kg. A fluid bolus of 20 cc/kg would be 1600 cc of IV fluid administered as a bolus to treat dehydration. For a dehydrated child I would advise half that as a safe dose of fluid (10cc/kg) to treat dehydration. These are personal rules of thumb that I have used in practice over the past several years. As always I advise due diligence when administering first aid to anyone. Training and experience can't be replaced by any FA manuals, regardless of how thorough. |