Gave a pt an entire bag of IV fluid the other day

[Dennhop]

So I gave a patient an entire bag of fluid the other day.




Pts distal circulation was crap, hands and fingers were cold, screwing with our pulse ox readings. Figured giving her a bag of saline out of our warming drawer to hold would warm her fingers up to potentially allow pulse ox to read correctly. It worked. So then I gave my district Lt a heart attack later when I saw him and told him I went ahead and gave my BLS pt and bag of fluid.

 

[STXmedic]

A bag really isn't all that much fluid, assuming they aren't a renal or CHF patient...

And did you not just have heat packs? Or, maybe, a bag of warmed saline for them to hold on to?...

And were you that concerned about hypoxia that you needed to start a line and give a fluid bolus just to get a number that, had it have actually been low, you should've been able to distinguish with a good assessment?

 

[hometownmedic5]

I don't get it. Why is administering salt water a big deal?

 

[Dennhop]

Or, maybe, a bag of warmed saline for them to hold on to?...

I went back through my post thinking maybe I had typed it wrong...But no, I typed it in right....This was exactly what I did...

 

[STXmedic]

So you didn't infuse anything? So what's the point of this thread?

 

[Dennhop]

Part humor. Part reminder of using what you have available to work for you. I do forget that Im not automatically identified on this forum as an EMT-B, so the humor gets lost a bit

 

[hometownmedic5]

Ok. I'm on to it now. I think I've sherlocked my way through this.

The OP, a BLS provider, gave their patient a bag of warmed saline to hold on to to warm their hands. Then, in an attempt to be pithy and clever, they told their supervisor that they "used"(having the subtextual connotation of "administered") a bag of saline on their patient, which would have been a no no as a basic. Then, I'm assuming based on the rousing, knee slapping response to this whiz banger of a joke they got at the station, it was taken on tour and presented here.

And boy am I glad I was here for the first performance...

 

[Dennhop]

My fault...Didn't realize any attempt at humor on this board had to be pretty approved by the board of directors here.

Tough crowd. Was planning on asking a few legitimate questions here, but seeing as how it appears that the attitude here is the same as in the services, where the old crowd and the new crowd don't seem to mingle well, I'll just hold my tongue and find my answers elsewhere. Sorry to waste your precious time.

 

[STXmedic]

I'm all for humor. Please, bring some. There just wasn't any in your post- only an intentional effort to be deceptive with your wording, making it sound like you did something you didn't. You also put it in the BLS sub-forum. Put your humor in the humor section and it may be better received.

And your questions are certainly welcome. There's a wealth of knowledge here from some very educated and experienced people. Just ask your questions directly and save the word play.

 

[Gurby]

Ok. I'm on to it now. I think I've sherlocked my way through this.

The OP, a BLS provider, gave their patient a bag of warmed saline to hold on to to warm their hands. Then, in an attempt to be pithy and clever, they told their supervisor that they "used"(having the subtextual connotation of "administered") a bag of saline on their patient, which would have been a no no as a basic. Then, I'm assuming based on the rousing, knee slapping response to this whiz banger of a joke they got at the station, it was taken on tour and presented here.

And boy am I glad I was here for the first performance...

Ohhhhhhhhhh! I missed the "to hold" part of the OP.

That's actually pretty hilarious.

 

[VentMonkey]

Tough crowd. Was planning on asking a few legitimate questions here, but seeing as how it appears that the attitude here is the same as in the services, where the old crowd and the new crowd don't seem to mingle well, I'll just hold my tongue and find my answers elsewhere. Sorry to waste your precious time.

 

[VentMonkey]

@Dennhop, seriously man we're about the same age, lol don't take it too hard. It's still a good forum with a lot of relevance to questions you may have.

Don't take the razzing as anything but either good fun, flattery, or both. You're in for a painstakingly long career otherwise.

 

[StCEMT]

Was planning on asking a few legitimate questions here, but seeing as how it appears that the attitude here is the same as in the services, where the old crowd and the new crowd don't seem to mingle well, I'll just hold my tongue and find my answers elsewhere.

Not true. There are people on here who have been doing this for a long time, quite possibly since I was in diapers. They are more than willing to help me sort out this new medic business I'm in when I ask for advice and call me out when I say/do something stupid, both to help me learn. The people here aren't interested in wasting time on petty things for the sake of being ****s.

 

[Tigger]

Wouldn't a hot pack have worked much better?

 

[CALEMT]

So I'm new to the whole medic thing and I'm still in school learning how to medic. Isn't the trend nowadays to not give patients a whole bag of fluid?

 

[hometownmedic5]

So I'm new to the whole medic thing and I'm still in school learning how to medic. Isn't the trend nowadays to not give patients a whole bag of fluid?

It depends. What are we treating? Some complaints will get small amounts of fluid. Some get lots of fluid.

 

[CALEMT]

It depends. What are we treating? Some complaints will get small amounts of fluid. Some get lots of fluid.

Yeah that I get. Some patients you can't give them enough fluids (i.e. sepsis) and others you want to withhold giving an excess amount of fluid (i.e. a CHF'er). My question is what is this guy giving a whole liter a fluid for. Reading the posts I'm kinda fuzzy on whats going on here. Is he administering IV fluid or is he providing a warm object for the patient to hold.

 

[StCEMT]

Yeah that I get. Some patients you can't give them enough fluids (i.e. sepsis) and others you want to withhold giving an excess amount of fluid (i.e. a CHF'er). My question is what is this guy giving a whole liter a fluid for. Reading the posts I'm kinda fuzzy on whats going on here. Is he administering IV fluid or is he providing a warm object for the patient to hold.

Sounds like warm object to hold. Between me and city EMS, I ran about 900cc into a guy the other night by the time he got to an ED bed. No cardiac history and pressures 70-90 the entire ride.

 

[medichopeful]

Some patients you can't give them enough fluids (i.e. sepsis) and others you want to withhold giving an excess amount of fluid (i.e. a CHF'er). My question is what is this guy giving a whole liter a fluid for. Reading the posts I'm kinda fuzzy on whats going on here. Is he administering IV fluid or is he providing a warm object for the patient to hold.

Sepsis is a fine balance. Overly aggressive fluid resuscitation in septic patients can actually be detrimental.

In this scenario, nothing was infused. He used a warm bag of fluids as a warm object. Smart idea, but misleading post.

 

[medichopeful]

Wouldn't a hot pack have worked much better?

Personally if they're not perfusing their peripheries well, I just like to go straight to pressors. Jump the gun a little, you know, mix things up. Keep it interesting.