Thank God we have IV access 15 seconds sooner

Sometimes I really wonder what people are really thinking. Wait – I take that back – I already have a reasonable idea of what most of our patients are (not) thinking. Sometimes I really wonder what my fellow co-workers are thinking based on what I see them doing (or not doing).

I came to work the other day and this is what I found in the ambulance:

What exactly was this last crew expecting to happen?

That is one spiked IV bag and, not one, but two flooded saline locks. Clearly the last crew to use this ambulance opened all the packages some 12-24 hours earlier to prepare these devices so that they’re “ready to go.” I’m not sure where, because none of it was used. It was “ready to go” to the trash, as far as I’m concerned.

Let’s set aside for a moment issues of sterility, aseptic techniques, general cleanliness of the patient compartment, infections and other unimportant topics. Everywhere I go, I see crews doing this. (OK, maybe not to this extent.) That’s a lot of opened but unused IV bags thrown out. Isn’t this perhaps a bit wasteful?

More importantly, what provider actually thinks s/he absolutely needs to start an IV right now at this very moment and not a second later that s/he feels it necessary to have these things pre-spiked? How long does it take to spike a bag? I don’t believe I’ve ever seen or heard of any patient who was wrested from the grips of death by an IV start that came just in the nick of time.

Seriously.

8 thoughts on “Thank God we have IV access 15 seconds sooner”

  1. I used to work as a “medic” in Los Angeles. Medic is a loose term here since all the medical director really wanted medics to do was to start that magic IV and drive fast. It was a horrible place to work as a medic. What’s worse is I knew medics that would sit in the ER parking lot getting the IV started instead of getting their critical patient into the ER where they belonged.

    Love the post.

  2. I agree its wasteful, but understand pre-spiking one bag at a time on a busy 911 truck. Once “popped” or spiked, aren’t bags only sterile for 12-24 hours? I’ve worked in a system where we sometimes prep, but also mark clearly the open time on the bag and not exceed 12 hours. We were also busy enough that we nnever threw one away.

  3. We would sometimes spike a bag ON THE WAY to a call, and that’s only if we thought this patient was going to need IV access. Most of the time, we’d spike on-scene or if ordered.

    I find it wasteful too, but that’s just me…

  4. Wasteful, unsanitary, and I can’t imagine what the pediatric patient with a fractured arm would think upon entering the rig!

    The IV fluid may be sterile in the bag but everything else has been exposed. Hell, what if the next patient that didn’t need the stuff was infectious and spooged all over with his coughing then the items were used on the patient after him? And don’t try to tell me that by leaving the package over the ends, it protects them. The package is open regardless.

  5. Our “Local Urban FD” keep a spiked bag of NS (granted, hung much neater than that disaster) and an unspiked but unwrapped bag of LR (dripset unwrapped and taped to the bag) hanging from the ceiling of their trucks.

    They look downright professional compared to your nitwits.

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