saline I.V.

[Okie]

It is pretty common, as I understand it, to give a basic saline .09 i.v. to someone recovering from traumatic injury, but I have come to understand that sometimes sugar can/should be added. What I am looking for is how much sugar should be added? percentage?

more information on saline i.v.'s in general would be welcome as well. thanks guys

[ibetiny]

I have worked in a trauma pharmacy for the past 5 years or so, to put it bluntly, if you have to ask that question you should not be attempting to shoot an I.V. at all. If you have any formal training such as an emt course or nursing school you should ask them. If you do not have any formal training you should do that first. Anything directly into a vein is very serious and should only be tried by someone who knows what they are doing pre or post SHFT.

Same goes with things such as sutures and even go-lytley. If you try to sew someone up in the field or even laying on your kitchen table they WILL get an infection, and you must be able to give large doses of abx to counter this, oral augmenten will not be enough. ANd they WILL die.

Even bowel prep can be dangerous. Go-Lytley is that gallon of stuff that cleans you out before a scope for colon cancer. On the package it says do not add flavoring. One guy decided that was bogus and washed it down with Mountain Dew. Go-Lytley gets rid of the solids but the bacteria is still present, and with all that sugar as food for said bacteria, a very large amount of gas was produced. When the surgon tried to biopsy he "blew up". 10 pints of blood later they called time of death.

Please for everyones sake get some training AND have good reference materials handy before doing ANYTHING. Not saying strictly not to do anything, but please be careful. Information like this should not be trusted coming from anyone not in uniform or in a classroom, even me.

Not trying to shut you down or make you mad (people STILL call me a nice guy, don't know why) just trying to keep people safe. Also if you still have questions I will try to help you, but this one could get my license revoked.

ibetiny

[monkeybird]

Here Here!!!

[Matt In Oklahoma]

First I would like to say i have the upmost respect for medical professionals but it is interesting because as someone who has administered IVs as a combat lifesaver in the Army and saved a few lives and kept some from going down with dehydration too, I still dunno what is in it or have a recipe, so i still "have to ask the question". ya know why, it's not covered, nor do the instructors themselves know. We have kinda discussed this in a past post but i'm still confused as to why i can bag'em there, leave them laying and continue to fight and hope someone finds them later but it's such a big deal here. why cant you make what is in there and still be helpful and keep them alive a few more hours till you can get "real" help ONLY during SHTF? What am I to do SHTF, just watch them go lights out after some looter shoots them?
BTW don't get yourself in a wreck answering but really, it's ok overseas in war but here it's all oh you gotta be certified and a whole lotta letters or your not reconized and you will kill them. if i'm doing this they are already dying, so nothing lost nothing gained right? sitting wringing my hands is not an option.
help me out

[monkeybird]

Matt, I think that the message is that you don't make your own IV fluids. N.S. or .09% saline, stands for normal saline, it has the same salinity as human blood, so that there is not shift of electrolytes when infused. D5W is 5% dextrose (sugar) in water. Lactated Ringers has a combinations of electrolytes. Lactated Ringers is the preferred fluid for trauma or blood loss. NS or D5W are often used interchangeably. D5W is not used with a diabetic, it can cause serious problems for them. NS and LR can be used with blood transfusions. D5W can NEVER be used with a blood transfusion.

The original question was regarding adding sugar to fluids. That will probably kill someone. Yes kill someone. Those who think they can just go to the kitchen and cook up a batch of IV fluids, need to consider the consequences. Any error in concentration or sterility will be deadly. I cannot imagine anyone trying to make their own IV fluids. You'd need to be a chemist and have sterile equipment and supplies.

As far as hanging a liter and going to the next injured person - that is not an issue. Using NS or LR to give fluids in the field is fine. Even if no one gets back to the patient, the IV will clot off after the fluid has infused. However, anyone getting more than a bag or two must be monitored for BP and other vital signs. Over infusion of fluids can also be deadly.

Any child who receives IV fluids must be monitored continuously, without fail! The small bodies of children cannot tolerate a lot of IV fluids.

[jmsneorrcom]

unless it is just for dehydration, you are going to have to stop what ever is causing the fluid loss IE. gunshot wound=surgury, if you dont do that, the patient is going to die anyway. you can only pour so much Normal saline in them. if its not a blood transfussion your just pissing in the wind. Ive been a paramedic for 23 years and my motto has always been for Trauma patients is they need a surgeon more than me.

[ibetiny]

Hey Matt and everyone, I'm having trouble getting across my meaning. And thats my fault. What I am trying to get across is a couple of things. 1st, mixing I.V.'s should not be done with anything outside of a sterile bottle. 2nd, I'm not telling you not to USE an I.V. just not to try to mix one on your kitchen counter. 3rd, Before you use an I.V. please have someone show you how first, and practice. Watching a video on the internet and thinking you can now save someone when SHTF is downright criminal. There are a lot of classes out there, some even free, that while you are there you can ask about I.V.'s. Take the time now and get your training BEFORE SHTF. I can talk more freely and probably more coherent in person. Also I can tell you what is in them, just not how, why or when to use them, if you get my meaning. Again, I can answer some SPECIFIC questions if you have them, and I will try to answer them as accurately as I can. If I have to I will ask some of the surgeons and pharmacists I work with. Try to have fun guys. (And I am deeply shocked not to have anyone comment on the story about GoLytley. It's true!!!!) lol. Perhaps our discussions could save someone in the future, so please ask.

ibetiny

[Matt In Oklahoma]

Roger this, I understand now!
BTW was that a Doo the Dew story? LOL

[Patriotic Sheepdog]

Okay, it is Normal Saline I believe you are talking about which is 0.9% not .09%. This is a big difference, but I'm sure it was just a typo.

Most cases I have used either NS or LR (Lactated Ringer's solution) for hypovolemia due to blood loss. Taking the time to add glucose to the IV will just take added time, not to say it cannot be done. There is D5NS which is a fluid that contains glucose and NS. If you are untrained in monitoring patients that are receiving these fluids, I would stick to using NS for fluid resusitation due to SEVERE blood loss that may result in iminent death. Administering an IV is not just sticking in a needle into someones arm and hooking up a tube witha bag connected. It also requires constant monitoring for extravasion, fluid overload, increased intracranial edema (with head trauma), cardiac arrhythmias, hypervolemia, hypertension and other potential problems. Of course in the PAW when someone is dying right there, you may have to do what you feel you need to do to save their life.

Try and get some training now if you can, EMT, Paramedic, etc. Read, study and try and learn some basics now so you will have an idea of what to look for and what is needed. Another option is get hooked up with a medical professional that shares your same preparedness views and form a group/team.

Normal Saline info....http://en.wikipedia.org/wiki/Sodium_chloride

[monkeybird]

You're right - those pesky decimals just get in the way!

[Patriotic Sheepdog]

You're right - those pesky decimals just get in the way!

Yes they do at times. I've done it more than once before myself.