Yesterday my partner and I had a patient, 90 year old female, found on the floor unresponsive by granddaughter. The granddaughter stated she stepped out to make something to eat, and when she got back her grandmother was no longer sitting but but was on the floor. We found patient on the floor awake, but disoriented, no motor weakness on left, but minor facial droop, slurring speech (as per grand daughter) and deviating tongue to the left, no arm drift. PMH High Chol, and 2 strokes granddaughter didn't know if there was a lasting defect. Meds: ASA and lipitor. V/s: B/p 130/90, 68 HR, 14 RR, pupils PERRLA CTC, pale, moist, warm, ECG NSR 12 lead I wish I had saved it to post however it was NSR no elevations depressions, only thing I had noticed was the QTC was 521. We treated with local stroke protocols, which is oxygen, Iv, notification and Diesel therapy (load and go.) During transport I looked at my partner, and said, want to give her some fluids as well? He asked a great question, why? My only answer was, I remember someone(I don't remember who) saying to do so, but the physiology behind it was a mystery, so we skipped the fluids. At the end of the night, My partner and I had just clocked out, and were throwing around a football in the snow, trying to burn off some energy, after a long night. One of the Dr's come's out of the hospital and joins our game, and proceeded to tell us the Stroke notification we brought in went right up to cat scan and they found only old damage, but after coming back down to the ER they found she was having a Non-STEMI MI ! They found an Elevated troponin level. Of Course this is not relevant to the main question, which is why or why would you not give IV Fluids to an acute stroke patient, and what the reason behind it is.
it's been in my experience that administering IV fluids ( normal saline ) at a t.k.v.o rate is not harmful and infact , if they need to admin T.P.A ( clot buster ) well they then have an IV access already established with your line and fluid running. I believe that as long as doing the line isnt delaying transport then its an acceptable practice and usually the nurses are thankful a line is running for them upon handover in the ER.
An intravenous line is inserted to provide drugs and fluids when needed at the hospital anyhow.
IV fluids for stroke pt's
in Patient Care
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An intravenous line is inserted to provide drugs and fluids when needed at the hospital anyhow.