the 100% directionless thread

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DesertMedic66

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DragonClaw said:
I get it, maybe you made a good save with a great outcome. You feel good and want to brag. Maybe you got to a pt in shock in the nick of time.

Putting the biggest needle into someone for kicks isn't it.

That's so egotistical. That's not a warm fuzzy feel good.
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Unfortunately some people will brag about anything. I always enjoy listening to someone brag that they have some medication or did some treatment that was completely not needed.
 
VFlutter

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Just curious, who has actually been on the receiving end of a 14g? Because personally I did not find the experience any worse off than any other IV start. I have placed many 14g in awake patients and they were not screaming or withdrawing in pain. Nothing inherently wrong with them given appropriate vein size and clinical indications.

Placed one the other day on a patient with a Swan'd Cordis that wasn't flowing fast enough. They are invaluable in many situations when massive flow rates are needed.
 
Jim37F

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VentMonkey

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Yerp. The PIO on the news said it was a hash oil factory. Righteously explosive. Guess some of the guys got hurt pretty bad; said it burned the seats off of some of their engines, too.
 
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Peak

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Unfortunately I think there are going to be some big lessons that come out of that fire, and probably some big changes to the way fire is fought in Cali. No more climbing on every roof, no going on the ladder without a SCBA and being on air.
 
Carlos Danger

Carlos Danger

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VFlutter said:
Just curious, who has actually been on the receiving end of a 14g? Because personally I did not find the experience any worse off than any other IV start. I have placed many 14g in awake patients and they were not screaming or withdrawing in pain. Nothing inherently wrong with them given appropriate vein size and clinical indications.
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That's what I was about to say. We're probably talking about like 3/10 pain for one second vs. 1/10 or 2/10 pain for one second……it's an IV start, not reducing an ortho injury or pulling an infected tooth. And "appropriate clinical indications" is pretty broad. I think you are always better off with a little more access than you expect to need.

If someone is intentionally trying to cause pain, they should be fired and reported to their licensing authority immediately. Keeping them on and instead removing large-bore angios is about the dumbest way I can think of to handle it.
 
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DesertMedic66

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Carlos Danger said:
That's what I was about to say. We're probably talking about like 3/10 pain for one second vs. 1/10 or 2/10 pain for one second……it's an IV start, not reducing an ortho injury or pulling an infected tooth. And "appropriate clinical indications" is pretty broad. I think you are always better off with a little more access than you expect to need.
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Obviously you have never seen @CALEMT attempt an IV start...
 
Akulahawk

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Carlos Danger said:
That's what I was about to say. We're probably talking about like 3/10 pain for one second vs. 1/10 or 2/10 pain for one second……it's an IV start, not reducing an ortho injury or pulling an infected tooth. And "appropriate clinical indications" is pretty broad. I think you are always better off with a little more access than you expect to need.

If someone is intentionally trying to cause pain, they should be fired and reported to their licensing authority immediately. Keeping them on and instead removing large-bore angios is about the dumbest way I can think of to handle it.
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For me, I'd say that a 20g is about a 2/10, 18g is about a 3/10, and a 14g is about a 5/10, but it's like a pinch - over and done with very quickly so it really doesn't matter much. Stubbing my toe on something hurts much worse and hurts longer.

I say that if someone is intentionally trying to inflict pain for a non-clinical reason, that's grounds for dismissal and consideration as to discipline against their license. There are a few instances where I'll intentionally inflict pain but when I do, it's entirely for clinical purpose and never more pain than necessary.
 
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silver

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VFlutter said:
Just curious, who has actually been on the receiving end of a 14g? Because personally I did not find the experience any worse off than any other IV start. I have placed many 14g in awake patients and they were not screaming or withdrawing in pain. Nothing inherently wrong with them given appropriate vein size and clinical indications.

Placed one the other day on a patient with a Swan'd Cordis that wasn't flowing fast enough. They are invaluable in many situations when massive flow rates are needed.
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To add an extra thought in the decision making process, for whatever its worth they are more likely to leave permanent visible scarring that a smaller diameter IV. Clinical indications!
 
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CALEMT

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I have come here to chew bubblegum and kick ***.... and I’m all out of bubblegum.
 
VentMonkey

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****ing John Carpenter. People truly missed the mark on great cinema these days. Over the top action mixed with cheesy sci-fi? Check.

FWIW, Alien Nation was also a solid go to. Maybe I’m just an Inigo Montoya fan, or maybe I just think Jimmy Caan was a dying breed of tough guy. Either way...
 
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StCEMT

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Carlos Danger said:
That's what I was about to say. We're probably talking about like 3/10 pain for one second vs. 1/10 or 2/10 pain for one second……it's an IV start, not reducing an ortho injury or pulling an infected tooth. And "appropriate clinical indications" is pretty broad. I think you are always better off with a little more access than you expect to need.

If someone is intentionally trying to cause pain, they should be fired and reported to their licensing authority immediately. Keeping them on and instead removing large-bore angios is about the dumbest way I can think of to handle it.
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Like I said, we've had issues with rooting out problem children vs blanket policy changes. We also had an employee(s) misusing the schedule that ended up leading to harassment or something? Not sure since the details they kept a bit tight on. We were told it was "to protect privacy". Either way, the solution was to block all field employees from being able to see who is on shift. Instead we can just see the shift number and if both slots are filled. So trying to find someone to swap a day with you is an unnecessarily difficult task. It's that grade school ******** of punish all for the actions of a few, but I'm just a field employee, my opinion isn't worth much.
 
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Peak

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StCEMT said:
Like I said, we've had issues with rooting out problem children vs blanket policy changes. We also had an employee(s) misusing the schedule that ended up leading to harassment or something? Not sure since the details they kept a bit tight on. We were told it was "to protect privacy". Either way, the solution was to block all field employees from being able to see who is on shift. Instead we can just see the shift number and if both slots are filled. So trying to find someone to swap a day with you is an unnecessarily difficult task. It's that grade school ******** of punish all for the actions of a few, but I'm just a field employee, my opinion isn't worth much.
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Considering that I’ve shown up to work with requests to place lines on multiple units, I wish that people couldn’t see my schedule.
 
Akulahawk

Akulahawk

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Peak said:
Considering that I’ve shown up to work with requests to place lines on multiple units, I wish that people couldn’t see my schedule.
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I'm almost in a similar boat... I have been asked to place lines on every in-patient unit in my hospital. Thankfully the in-patient units can't generally see my schedule. When they need a line placed after they've failed (and it's after hours), they call the ED for help. I then get "asked" to go help them. While I'm there, it's not uncommon to be asked to do another one or two...

If they could see my schedule, I probably would get more frequent requests because they know that I'm really good at it.
 
Tigger

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My AMR Springs op was forced to pull 14ga IV catheters after city fire's EMS people decided that a 16 has "almost the same flow" and "we do permissive hypotension now."
 
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StCEMT

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Tigger said:
My AMR Springs op was forced to pull 14ga IV catheters after city fire's EMS people decided that a 16 has "almost the same flow" and "we do permissive hypotension now."
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I can get by with permissive hypotension, doesn't mean I don't prep my patient for mass transfusion. 🙄
 
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