[GENT]

I have seen a good few posts here of people asking how to cannulate, 'Give IV's' Fluids, making your own fluids etc.

There are other options to consider!

Intravenous anything is an invasive procedure which can easily lead to a whole host of problems when given improperly... http://en.wikipedia.org/wiki/Intravenous_therapy#Risks_of_intravenous_therapy

Something i have not seen mentioned is Rectal administration of Fluids

here are two papers on the topic;
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2658148/pdf/3.pdf

and an experiential account;
http://www.fileden.com/files/2010/4...stered Fluids in a Wilderness Environment.pdf

I implore you to read up on it.

Many lives were saved in the Falkland’s by normal soldiers trained in this.

In one of the above links it describes that its use has indeed declined due to better technology, medicines and training now available- all of which are lacking in my target audience.
It was used extensively in WW1 for example, an environment where hospital care was unavailable, no modern "MEDEVAC", infection was high, drugs in short supply and training limited… take the hint…

It can be administered using a drinking bladder (e.g. camel back) and has little or no risk of infection, embolism and other risks associated with IV's.

It is far far safer than intravenous infusion, and it has and will continue to save lives. With an IV, in many cases you are more likely to kill the casualty especially considering this is often considered in the context of long term SHTF/EOTWAWKI where there will be no true hospital care to make up for any mistakes.
(i have read on here peoples plans to mix their own IV solutions without a lab post SHTF etc... some scary stuff is discussed here!)

For inexperienced people (YouTube does not count- med school does) a non invasive treatment is always preferable unless there is no other option.
it may be somewhat less effective- but you also have a far reduced chance of killing the person you are trying to save.
I do not pretend that it is as effective- but where the materials and training are not conducive to proper cannulation- and where no hospital care and no drugs are available to tidy up your mistakes- it just makes sense.

it may not be as Rambo, romantic, cool or not what you have seen on TV, or not fit in with the image you have of yourself becoming all capable once TSHTF, but it works.

This is simply my own reasearch and logic on the topic.

Disclaimer;
I am not a medical professional, I am not advising anyone carry out anything, always consult your doctor.

 

[GENT]

I was going to post in this thread, but decided it might derail so i will direct pople here; http://www.survivalistboards.com/sho...d.php?t=181118 with regards to an alternative that is much safer than IV, and using the example below would IMO be far preferable for something like Dehydration than a reletively risky IV procedure.
Have stated in the quote below where i think the above discussed alternative would be an acceptable and safer alternative in red.


Quote:
Originally Posted by Jedi Medic
But since you asked:

IVs.

legality: IVs are one of those medical procedures deemed necessary to be performed by an MD. Human supplies have the words "Use by or on the advice of a physician only". Veterinary supplies do not. Most medical care given to animals on farms, etc is done by the owners. I've seen identical supplies with and without the same wording.

This is very barebones info. Its here mainly because of some of the uninformed opinions on this thread. There is always more to something than what you think there is. This is especially true with medical care. why else would a doctor spend 3 years in med school, then another 3 years interning to learn his trade ? Paramedic training is 2 years condensed into one. EMT training is one-semester and doesn't really cover IVs well enough to teach them effectively.

My only advice to the masses regarding this, is that IVs are most effective on dehydration than anything else, so save them for that alone.

as far as an untrained person doing it on someone else; pre-SHTF, hello lawyers. Post-SHTF, who cares.

therapeutic use:

1.) restoring fluids/electrolytes in dehydrated/heat exhausted people unable to retain water given orally. also impt for burn victims. Ideal for this situation

2.) temporarily slowing the effects of serious blood loss due to hemorrhage. IVs will not replace lost blood and will only artificially raise the blood pressure. The leak must be stopped, the only cure for that is surgery. Whole blood or RBCs must then replace the lost volume. Raising the BP too high with IV fluids can hasten blood loss. It's not a simple procedure and there isn't enough space here to cover it. Not as effective, but still far safer, easier and can be done with minimal or zero training- alternative method has been used for trauma

3.) as a means of giving IV meds.

contraindications:

1.) fluid overload. this can be seen in the elderly with a weak heart. Too much IV fluid can back up into the lungs and drown them, much like one would see in congestive heart failure. still a slight risk

2.) In infants, they can only process so much volume at a time. it is important to measure and carefully administer IV fluids in children down to the Kg. alternative in some cases preffered to IV for this reason

complications:

1.) besides fluid overload, the electrolyte balance can be upset. This can cause cardiac arrhythmias that can be lethal. detecting this and dealing with it require cardiac monitoring and lab work.

2.) complications from the stick; infection from a dirty needle or site, embolism from air entering the blood stream, thrombus from damaged IV catheter or vein. NO RISK using alternative

3.) placement. use the largest catheter size you think you can succesfully start, the larger the catheter, the faster the fluid will run in. IV catheters are numbered backwards. a 24 ga would be very small and suitable for children, old people, people with crappy veins. a 14 gauge is vary large and would,be suitable for someone with good veins that needed a lot of fluid quickly. NOT AN ISSUE

3a.) placement. use veins in the crook of the elbow or higher (closer to the heart). avoid using veins in the legs/feet, unless as a last resort due to complications and decreased fluid return. NOT AN ISSUE

Fluid choice. same fluids can be used

IV NS or "0.9% sodium chloride for IV use" aka "normal saline" matches the human bodies salt concentration. there are "saltier" fluids that have their place. They require more attention (as mentioned above) than this forum allows.

IV LR aka "lactated ringers" or "hartmanns solution" a better volume expander, but still temporary. Has more potassium than NS and can be beneficial, but can cause cardiac arrhythmias in high doses.

IV D5w, D10w, etc. "5% dextrose in water for IV use" has it's place with rehydration but not at the entry level and not the first choice. mainly used as a meds line. has no effect on shock/blood loss.

use:

dehydration; where the pt is unable to swallow due to lowered level of consciousness, vomiting, heat stroke.

trauma; where blood loss has caused a drop in blood pressure/elevation of other vitals signs. read above caveat. infuse only enough to lower pulse rate. keep systolic BP around 90mmHg. Too much IV fluid in a trauma pt can dilute what RBCs that are left in circulating volume, wash out formed clots.

AFAIK: using the vet technique of the "fluid bubble" works great on small loose-skinned animals. I saved a parvo puppy with this and Orbax alone. Doing this same thing to a human would be extremely painful and useless.

As said- please reply in the linked thread to avoid derailing

- from here; http://www.survivalistboards.com/showthread.php?p=3028581&posted=1#post3028581

 

[GENT]

Just found another great source of info on this!:

http://vincetremayne.com/resources/Emergency+rectal+infusion.pdf

it actually talks about remote nursing, lack of knowlege etc awesome link!!! along with procedure guidance!

 

[Hard Hittin 54r]

Thanks for the good information.

HH54r

 

[FarmerJohn]

honestly tho if your pushing straight saline its pretty hard to screw someone up most people are dehydrated anywhay in there day to day life 500ml or a 1000ml isnt going to ruin anyones day if you give em one now if your using one with hexten in it thats a different story

but ivs are pretty safe

 

[GENT]

honestly tho if your pushing straight saline its pretty hard to screw someone up most people are dehydrated anywhay in there day to day life 500ml or a 1000ml isnt going to ruin anyones day if you give em one now if your using one with hexten in it thats a different story

but ivs are pretty safe

I agree- IV's are fine and fantastic if administered by properly trained personel with the correct equipment, fluids and conditions.

 

[FarmerJohn]

I agree- IV's are fine and fantastic if administered by properly trained personel with the correct equipment, fluids and conditions.

correct equipment? like the iv bag line and needle? theres no other equip i can think of you need

an conditions? were not talkin brain surgery here

you can put an entire iv lines worth of air into a person and theyl be fine it takes alot of air to cause an embolism and from all my readingits about 3-8 cc of air per kg to cause a cardiac arrest its not like tv were one syringe does em in

 

[jfirebalrog]

I actually have set-ups for this in my pack.The main limitations are the volumes that can be infused .The last Journal of Special Operations Medicine training supplement reccommends 300cc/hr for adults as a normal max but up to 500cc/hr for shocky patients.The set-up I use is a 16fr foley with 30cc balloon(don't get the 5cc) ,a small tube of KY, ORS and a 500cc gravity feeding bag set.I also include a 18fr gastric tube, so I can run it in that direction as well(important for severe diarrhea). There was also a story about it being used for an abdominal trauma(something I would personally be reticent to do) in one of the wilderness medicine blogs.

As far as improvising using a camelbak,lube it up ,use a hemostat or small vise grip to controll the flow, tape it in place.Just make sure you don't use your own camelbak or mine!!!LOL

 

[SOTSDoc]

As a PA and prior special operations medic, my best recommendation is to attend a tactical training course where you will get hands on training on how to properly give fluids. My company along with my others teaches courses that are occasionally open to the public. I would recommend you seek out a reputable instructor and learn it....this is not something that should be learned over youtube.

 

[helliott123]

As a PA and prior special operations medic, my best recommendation is to attend a tactical training course where you will get hands on training on how to properly give fluids. My company along with my others teaches courses that are occasionally open to the public. I would recommend you seek out a reputable instructor and learn it....this is not something that should be learned over youtube.

how long is you tactical training course and what does it cover?

 

[SOTSDoc]

The majority of our courses are for military only. That being said we offer two courses to the general public, tactical medicine and disaster medicine. The tactical medicine course is a day long and covers medical treatment for major traumatic injuries while under fire. The disaster medicine course covers a lot of the same topics as the tac med course, but on the second day we focus on long term medical care without the use of medical facilites or equipment. Check out our website when you get the chance for further details. I honestly believe we put together the best tactical medicine course out there thanks to all our intructors who are veterans of the special operations community. Our website is www.specopsts.org