I've taken a few off-grid medicine classes taught by ER doctors. The first skill students always want to learn is suturing. Most people have had stitches; most can see a need for it in the future.
The second skill is how to start an IV. You're not going to learn that here, not from me. Not today, not ever.
First off, finding a vein is something even nurses and phlebotomists struggle with at times when everything is good. They were never happy about finding a suitable vein in me when I had routine blood work when I was pregnant or in the hospital delivering the baby. Sometimes after a few unsuccessful sticks, they'd resort to calling in someone more experienced.
Now, imagine the patient is dehydrated, or small, or elderly--small veins are much harder to find. And you are significantly lacking in experience.
Thirdly, an IV, especially in a challenging situation where you are doing the best you can with very limited resources, always risks introducing infection right into the bloodstream. You just don't want to go there if you don't have to.
Hypodermoclysis, also known as proctoclysis, is the subcutaneous administration of fluids. It's a means of replacing lost fluids when a person is too sick to eat or drink due to weakness, nausea, vomiting, or diarrhea. It can also be used to administer medications, including antibiotics and pain relievers, when they can't be taken or tolerated orally.
Hypodermoclysis has been used as a method of replacing fluids for nearly a century. And you don't need specialized equipment or training to do it. Nurses around the world routinely train a patient's family members on how to carry out hypodermoclysis to care for their loved ones at home.
Supplies needed:
- Small gauge needle and catheter
- Enema bags and tubing
- Paper tape
- Disinfectant
- Sterile saline or oral rehydration solution
The process is quite simple. The enema bag (or IV bag if you have it) is filled with the oral rehydration solution, and the tubing, needle, and catheter are connected. The doctor or nurse will disinfect the site selected for administration and demonstrate how to insert the needle and catheter under the skin of the thighs, abdomen, chest, back, or arms. The catheter will then be taped in place. Up to 45 ounces of fluid can be administered per day in two different locations.
What if you don't have a needle and catheter or sterile saline? You've got one more option for replacing fluids: Simply use an enema bag and administer fluids and medications rectally. This is also the best option for rapid fluid replacement in cases of severe dehydration.
Links to related posts:
Enema bags for rehydration and warming
Tapes and Wraps
Dehydration (coming September 30)
For further reading:
https://www.aafp.org/afp/2001/1101/p1575.html
https://www.aafp.org/afp/2001/1101/p1575-s1.html
https://jamanetwork.com/journals/jama/article-abstract/429786
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4946820/
https://pubmed.ncbi.nlm.nih.gov/14698495/
https://www.semanticscholar.org/paper/Administration-of-antibiotics-subcutaneously%3A-an-Azevedo-Barbosa/9997d804001a15101b213f8f0ff95c1ea269bc45
9.6.22
While useful with improper technique you can cause life threatening infections while trying to rehydrate someone. A Rectal Enema also works well. And unless you use blunt force trauma inserting the enema your very unlikely to perforate anything and thus avoid infections. Rectal Enemas also can be used with clean drinking water as sterile IV bags *might* be hard to get when the riots destroy your local hospital.
ReplyDeleteOy my bad I didn't see the last sentence where you talked about rectal enema hydration. Sorry.
ReplyDelete