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Posted: 2/12/2024 2:11:57 PM EDT
Where can I buy IV fluid bags (including the fluid) and tubing?
I’m not willing to go gray market for IV fluids. If they require a medical license, we can ask a doc if they are willing to get a group buy. This wont be a big purchase, and it wont be ongoing. Anyone have a source? |
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Words fall from your mouth like shit from ass.
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Jase case worked for us.
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This is relevant to my interests as well.
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If you're referring to 0.9% saline solution, I'm pretty sure you can buy those anywhere that sell medical supplies.
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I survived the cockpocalypse of 11/21/2012.
Bacon grease, the Muslim approved .mil lubricant. |
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"According to Argonne National Laboratory, it takes 100 pounds of battery in an EV to go a distance achieved by only one pound of gasoline in an ICE vehicle"
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Originally Posted By hobbez84: If you're referring to 0.9% saline solution, I'm pretty sure you can buy those anywhere that sell medical supplies. View Quote That is my question. I’m quite rural, I’d have to drive to a big city for a supply house. Then once I get there, I’d have to deal with their policies. Rather order it online with a known outcome. I’ll try the links. Thanks. |
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Words fall from your mouth like shit from ass.
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Originally Posted By zoe17: Here View Quote Thanks for that, book marked for the Mrs. to look at later, I mentioned it to her and she said lactated ringers would be the main thing to be interested in. (wife=35 year surg-tech). |
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Platinum status courtesy of Rudukai13, don't worry mods, I know i'm still on my last warning, lol, sorry about that, i'll play nice.... at least for a year...
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Bigger question is why.
Unless you have cholera, vomiting or are mixing meds, IV fluids are usually not the preferred rehydration solution. Oral is. If you're thinking trauma, crystalloids have fallen far out of favor - salt water doesn't save lives, blood does. If you just want a better hang-over cure ... well, it actually works pretty well for that. |
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Originally Posted By NotIssued: Bigger question is why. Unless you have cholera, vomiting or are mixing meds, IV fluids are usually not the preferred rehydration solution. Oral is. If you're thinking trauma, crystalloids have fallen far out of favor - salt water doesn't save lives, blood does. If you just want a better hang-over cure ... well, it actually works pretty well for that. View Quote Vomiting, this is the majority of the reason I want them. Crystalloid does save lives in trauma. Absolutely. It buys the victim some time until you can get them blood. If you have a study that compared absolutely no resuscitation and then blood an hour later, versus immediate resuscitation with crystalloid then blood an hour later. Please link it. Alternatively if you have a legit vendor that will sell blood products to regular folks, let us know that. |
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Words fall from your mouth like shit from ass.
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Originally Posted By Steamedliver: Vomiting, this is the majority of the reason I want them. Crystalloid does save lives in trauma. Absolutely. It buys the victim some time until you can get them blood. If you have a study that compared absolutely no resuscitation and then blood an hour later, versus immediate resuscitation with crystalloid then blood an hour later. Please link it. Alternatively if you have a legit vendor that will sell blood products to regular folks, let us know that. View Quote Lord, you're so wrong. Well.... sort of. There's what type of injury (penetrating, blunt, head.... etc), type of crystalloid, volume given, time to blood products... anyway: Crystalloids help.... how? Salt water provides no oxygen or CO2 transport capability. Crystalloids can impact coagulation and worsen it Crystalloids are often room temp, causing a drop in body temperature which also worsens coagulation Maintaining a "normal BP" just means you pump out blood faster. About 3/4 of crystalloids leave the blood vessels and diffuse into the interstitium (time depends on a lot of factors). Over resuscitation with crystalloids can cause pulmonary (and tbh, global) edema. Should I go on? Google "trauma resuscitation with crystalloids" There's a ton of hits. Definitely mixed info, but leading towards over "2 Liters is bad, and less may be bad too." Current ATLS and TCCC guidelines really push back on them. Control the bleeding first. Worry about volume replacement later. But if you plan to give crystalloids, it's probably best to give enough to maintain enough pressure to keep the patient mentating appropriately, but no more. link to summary As to your second point, I'm not aware of any easily available blood products. |
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I'd personally give LR or NS if I didn't have blood. Titrate the BP to 90 systolic to avoid "clot busting". As stated the patient would do much better with blood. Knowing your blood types and having transfusion kits available is not a bad idea.
If you can stabilize the patient long term care is going to be your next biggest concern (something else to think about) |
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Originally Posted ByNotIssued: Lord, you're so wrong. Well.... sort of. There's what type of injury (penetrating, blunt, head.... etc), type of crystalloid, volume given, time to blood products... anyway: Crystalloids help.... how? Salt water provides no oxygen or CO2 transport capability. Crystalloids can impact coagulation and worsen it Crystalloids are often room temp, causing a drop in body temperature which also worsens coagulation Maintaining a "normal BP" just means you pump out blood faster. About 3/4 of crystalloids leave the blood vessels and diffuse into the interstitium (time depends on a lot of factors). Over resuscitation with crystalloids can cause pulmonary (and tbh, global) edema. Should I go on? Google "trauma resuscitation with crystalloids" There's a ton of hits. Definitely mixed info, but leading towards over "2 Liters is bad, and less may be bad too." Current ATLS and TCCC guidelines really push back on them. Control the bleeding first. Worry about volume replacement later. But if you plan to give crystalloids, it's probably best to give enough to maintain enough pressure to keep the patient mentating appropriately, but no more. link to summary As to your second point, I'm not aware of any easily available blood products. View Quote Is it your position that if someone does not have access to blood (but have access to crystalloid) that giving crystalloid to have some semblance of blood pressure is a detriment. Is it your position that in the absence of blood products, it is better to NOT give any crystalloid? Even if that could be an hour or more? I would absolutely love to see the research in this specific scenario. That crystalloid is always bad in hemorrhage, even when blood product administration will be delayed. @NotIssued. Absolutely go on. I would like to see how far you can dig yourself into this hole. |
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Words fall from your mouth like shit from ass.
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Originally Posted By Steamedliver: Is it your position that if someone does not have access to blood (but have access to crystalloid) that giving crystalloid to have some semblance of blood pressure is a detriment. Is it your position that in the absence of blood products, it is better to NOT give any crystalloid? Even if that could be an hour or more? I would absolutely love to see the research in this specific scenario. That crystalloid is always bad in hemorrhage, even when blood product administration will be delayed. @NotIssued. Absolutely go on. I would like to see how far you can dig yourself into this hole. View Quote @steamedliver I gave you a link. Prove that crystalloids are good. There's no absolutes in medicine. But if you're BP sucks enough (presumably from trauma, in this instance) that you need over an hour of IVF to keep your alive, good chance you'll die in the ICU anyway. |
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Originally Posted By NotIssued: @steamedliver I gave you a link. Prove that crystalloids are good. There's no absolutes in medicine. But if you're BP sucks enough (presumably from trauma, in this instance) that you need over an hour of IVF to keep your alive, good chance you'll die in the ICU anyway. View Quote I’m so thrilled you tripled down. Here you go. Maintaining cardiac output and BP by judicious use of crystalloids is shown to improve outcomes when blood products are not immediately available. Dying in the ICU? So that’s a reason not to try? Just asking. |
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Words fall from your mouth like shit from ass.
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I’ll throw in my 2 cents here. This is based off when I retired two years ago (FF/paramedic). 20 years ago a trauma patient got two large bore IVs and fluid wide open until you got a systolic of 90. We learned to dial it back and went to a slower drip, but still to systolic of 90. Outside of the military and some very forward thinking departments, most agencies don’t have blood products to push. Even for the military, they don’t carry them in the field, they just use their vampire bags to get blood from other troops.
No one would deny blood is the best option, but LR or NS is better than nothing. Oral rehydration is great, but if someone is so heat stroked out, it’s more efficient to use IV fluids. Burn patients absolutely need fluids. So with all that said, I would say that having LR or NS on hand is a good option as they can be used to treat various things. |
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Here is a JEMS article from a guy.that is way smarter than me in trauma.
This article I didn't read the full study but the authors considered it a benefit that after NS administration there was less vasopressin and catecholimines measured in the blood and also found that MAP did not improve over all with small amounts of saline long term. From the article you sited: "Delayed fluid resuscitation is preferred when transport time to definitive care is shorter whereas goal-directed resuscitation with low-volume crystalloid is preferred if transport time is longer." It also points out that we shouldn't be dumping a liter in people and not trying to replace everything lost but instead should be doing 1-200ml's at a time. If the persons MAP is >80 we shouldn't be giving them any. |
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They have home IV services. The nurse comes in and hooks you up. Safer then trying to dig into your veins by yourself.
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