Jump to content

Where to place an IV.....


FireEMT2009

Recommended Posts

ABCs do always come first. Define respiration. Compare that to ventilation. What's the difference between the two? How does that difference apply to what you're trying to say?

Ventilation is the act of moving air in and out of the lungs from the outside in or vice versa.

Respiration is the act of the transferring of oxygen molecules to carbon dioxide molecules which is what happens at the aveoli-capillary level.

I need to fix my signature cause I can not truly cause respiration due to having no control over a person's respirations. I can cause them to ventilate. I will correct it ASAP. Thanks Mike!

FireEMT2009

  • Like 1
Link to comment
Share on other sites

In a few places paramedics can start arterial lines. This is usually reserved for true critical care paramedics, and the lines are used for invasive pressure monitoring, not for med / fluid administration!

If you were to have problems with peripheral IV access, and you need to give a medication desperately that can't be given by any other route than IV / IO, then the IO seems like a good solution. If for some reason this isn't an option, if your scope allows it, a central venous line would be the next obvious step. Very few places do many of these any more, as the IO works pretty well.

Giving meds arterially presents a host of problems. The drug has to pass through the distal tissues before it can enter the venous tissue, and will be present in much higher concentrations there than when given intravenously / systemically. There's also a chance they get partially metabolised. Not to mention, that starting an arterial line on purpose is a lot more difficult than starting a venous line on purpose.

If you can not get an IV started and meds are desperately needed can't you inject directly into the vein or go for the bum? How about a sublingual injection? Absorption should be pretty quick SL.

Edited for sp.

Edited by DFIB
Link to comment
Share on other sites

There is a popliteal vein, too.

Initiating an a-line in the field is outside of your scope of practice. If your supervisor intentionally went for an artery, no matter where it was, he was wrong to do so.

I did not know there was a popliteal vein, although it makes sense now that i think about it.

What do you mean by 'go for' and 'went for'? You don't mean intentionally do you?

Yes, it was intentional....and unsuccessful.

Link to comment
Share on other sites

If you can not get an IV started and meds are desperately needed can't you inject directly into the vein or go for the bum? How about a sublingual injection? Absorption should be pretty quick SL.

Edited for sp.

Injecting directly into the vein is called mainlining. It's what heroin addicts do. In every place I've worked it has been frowned upon or just outright not allowed. In one place I think it was even illegal.

As for sublingual injections, well, that would just be painful. Would you open your mouth for someone wanting to stick a needle under your tongue?

Link to comment
Share on other sites

As for sublingual injections, well, that would just be painful. Would you open your mouth for someone wanting to stick a needle under your tongue?

Depends, If it is a needle under the tongue or a 20 cc syringe up the butt ..... hmmmm ..... the needle doesn't seem that bad. :o

Injecting directly into the vein is called mainlining. It's what heroin addicts do. In every place I've worked it has been frowned upon or just outright not allowed. In one place I think it was even illegal.

I am interested in why IV injection would be called "mainlining" among healthcare professionals and be frowned upon or made illegal. I understand phlebitis is a concern but can be avoided by proper dilution of the meds. Would you please explain.

Edited by DFIB
Link to comment
Share on other sites

You can always stick an ETT in their anus, and push any med you need.  If you are conscious enough to refuse a SL stick, you probably do not need an IV.  But if your IV success ratio is less than 95%, it is more about you than it is the lack of veins.And if you have vein big enough to "mainline" in, then you should be able to get a 20 or 22ga IV catheter in it as well.

Edited by flamingemt2011
Link to comment
Share on other sites

I don't think I would mind the sublingual needle that much. I means they could inject right under my jaw. Seems preferable to violating my "exit only" orifice.

Link to comment
Share on other sites

I am baffled as well about why anyone would want to cannulate an artery.

DFIB...the popliteal is behind the knee. Why would you want to start one there? and as for a sublingual injection?? I've never heard of that. Well except in the dentists office when he is poking me with needles in my gums but never under my tongue.

And all I can muster in my head to say to flaming is this....WTF DUDE!!!! I'm pretty sure a tube in thier butt is about as effective as giving meds down a tube in thier lungs... :confused:

Link to comment
Share on other sites

×
×
  • Create New...