Greetings all.

Question: Do any of you include IV supplies (needles, tubing and IV fluids) in your supplies, and if so, where'd you get it?

My daughter's recent bout of nausea / vomiting a couple of weeks ago and the isolation and overwhelmed emergency services that some experienced after Katrina got me thinking.

I'm a nurse and can start an IV in a heart-beat but getting the supplies (don't want to swipe them from work) is the issue at hand.

I keep a well stocked ALS kit with my gear, I am lucky enough to own a company that provides ALS medical service for events, allow me to legally purchase pharmacuticals in my scope of practice.

You will just have to find a vendor who will sell the supplies to you, although be forewarned doing so is illegal.

Maybe you could get a prescription from your family doctor?

Sue

That is how I have been supplied in the past, but the doc knew first-hand that I can start an IV. Worth discussing with your doc.

I have a fully stock kit in the car and home. I get supplies from work since pretty much everyone knows I prefer to use my own bags when working solo. Also being in supervisory position I back up some of my guys when they screw up. Asking your doc for prescription is one way to go. Other way is telling your supervisor that you need stuff for home and with amount of supplies that hospitals waste I don't think start pack and NS bag would be a problem. SInce you are a nurse I don;t think anyone would give you a hard time.

Hope your lil girl feels better.

For the great unwashed, starting an IV without proper training can be the trail to disaster. You can make a bad situation a whole lot worse incorrectly pokeing around in their hand or arm with a needle. Infection, nerve damage, air embolism,......etc.
If your doing it on someone else, there is the potential for legal issues should there be anything but a completly positive outcome should you not be currently certified.

"There is nothing so frightening than ignorance in action."

That being the case, can anyone advise the forum as to were such training might be obtained? US and/or UK. Other than in the emergency services or the armed forces that is.

Thanks for the info. That's given me some ideas.

I was thinking about a couple of NS bags (saline) for emergency hydration for family or myself though the thought of starting a line on myself would be tricky/intereresting/comical since I'm used to doing it to someone else and have use to both of my hands.

Oh well, Semper Gumby (ever flexible).

<img src="/images/graemlins/grin.gif" alt="" />

That would be it.

I can kill you with an IV almost as fast as I can with a knife. I know how to use the latter, but not the former. This can be a ZERO forgiveness procedure if you screw up. I could do an IM if it was "he dies in ten minutes if you don't" situation, but IV's, no way. And even then, the IM would be something like an epipen that is prepacked.

To quote my sister-in-law, who is an EMT-I, if you have to do a stick, you better be able to hear the sirens or see the lights, or have the [chopper] on the radio and the LZ within 10 minutes walk with a litter.

Unless you can do more than JUST start an IV...

While having the ability to start an IV and administer fluids is nice, there are typically better ways to fill your pack. I do have a HUGE medical kit with IV supplies as well as other Advanced Life Support Supplies; however my BOB and backpacking medical kits don't have IV supplies in them. I add additional ALS & IV supplies to my pack as needed when my mission requires.

As for training, learning how to start an IV is easy; all the other knowledge that goes along with that skill is a different story. Taking a class to learn how to start an IV is not a trivial process, typically this means taking the classes to become a nurse or EMT Intermediate or Paramedic. Either route is at least a year long process, with RN and Paramedic being a 2-4+ year long process.

So, I am having problems posting long messages again... so part II of above post:

Take a First Responder class instead, you'll learn more important life saving skills than starting an IV and it is only a 40-60 hour commitment. A Wilderness First Responder Class would offer more pertinent information and training for the survival setting.

Wilderness Medical Associates, Stonehearth Open Learning Opportunities and, National Outdoor Leadership School all offer good Wilderness First Aid and Wilderness First Responder programs. While I have only taken medical classes from S.O.L.O., I have taken courses from all three of these organizations and can, without hesitation, recommend each of them.

Romania, any good on-line resources for EMS First Responder training? I'd like to get my hands on the materials. I missed the entry last year. I had prior committments, so I couldn't attend enough of the classes to complete the course. I'd like to bone up and read all I can before this year's round.

By on-line, I mean, do they have all the in-class materials posted and maybe even practice exams or at least homework style questions?

Thanks!

EDIT: I'm overtired. I completley forgot SOLO is in Conway, never mind. :P Less than two hours from me, and I'm asking where I can retake the class... *shakes head*

You might consider stocking oral rehydration solution as an alternative to IV supplies. A trained person isn't necessary, which is important if you are not around to administer the IV or otherwise not able to do it (e.g. what if your strong hand were injured?). Of course, in situations when you really need fluids fast, you need an IV, but for conditions like dehydration from vomiting/diarrhea, a supply of ORS should suffice and can be prepared by anyone.

Iron,
No worries... I grew up in Hinesburg, was nice having Conway only a few hours way to take a class

Mascare,
Red Cross has a decent MFR program, but beyond that I don't know of any online resources for MFR. I'd get a copy of the book and workbook that the program you'd like to take is using and do the study questions and workbook. That would be excelent preperation for class, but you can't beat the hands-on experience you'd get in a good class.

Most of the online study resources for EMS are mostly Paramedic Level stuff.

Thanks Romania. I checked online and they are mostly "how to pass" the exam stuff and none of it looked free. I'll talk to the instructor to see if I can get the materials so I can study prior to going to class in the fall.

Being a nurse I'm sure you know that any thoughts in this regard should be for family only. Your license would be at risk were you to try to help non-family and have them (or their relatives) come back and sue you later. That's for LPN's and RN's ... an NP can do this without direct or standing orders, order it yourself (this may depend on your state however.) In a true disaster situation, I guess you could just stick-and-run, and never tell them your name. <img src="/images/graemlins/shocked.gif" alt="" />

You would also need to find a friendly doc in the ER who might cut you a deal to rotate stock so it doesn't expire on you.

When I was a paramedic way back when (I'm expired now) I never viewed IV's as something necessary for a home kit. The fluids might tide you over for large blood loss until you can get into surgery. But your scenerio leaves you with a lack of medical service so I'm not sure IV fluids would be all that useful for that "golden hour" trauma scenerio. For your scenerio, IV's would fall more into the "convenience" category for dehydration, IMHO. If somebody is sick enough that they are actually dieing of dehydration, then medical care is necessary. A do-it-yourself IV at home isn't likely to fix the problem.

Of course, when your own family is concerned, nothing is too outrageous. So if you can get the IV equipment without stealing, and store it so it remains sterile, and you monitor expiration dates ... go for it. I probably would myself if I lived in a disaster prone area, even though I'm making a counter-argument in this very post.

Question to the medical personel here-

For you guys (and gals), due to your training, would bugging out be considered something akin to desertion?

A lot of my family is medical, but I've never thought to ask this becuase their plan is to be on the a load out with the patients, or then rotate to the fire department.

I'll be headed to the Fire Station if I am able to. My preperation plans and BOB kits are for when I am not in town or going to the fire station isn't an option. In an emeregency my place is on the engine.

I took my Wilderness First Responder from WILDERNESS MEDICAL ASSOCIATES. As an over all couse, it's more rounded and teaches you to think out of the box, than an EMT class. Infact it teaches you things you can't (by Law) use unless your 2 hrs away from definitive care; these are the Wilderness Prodcals.
You even do a live injecting with Saline. This is a very good Course;
The instructor's name was Cabit, and he's one of a handfull of full time instructor's. I think it's better to get a fulltime instructor who really knows and can teach the information

For me personally, I have never had the need to bug out. None of our local/regional emergencies/disasters have resulted in a situation where it was necessary to leave the area. For almost all major storms, I report to the Fire Station. My family for the most part can handle issues at home.

If a situation arose where bugging out was necessary, I would make sure that had what they needed and got off safely. I would report to the Fire Station for as long as the situation required. My family knows I would never leave the area as long as my services were necessary.

Pete

In theory yes... but it will be more of the disciplinary action against you for not showing up. After all unions are very powerful as we've seen during recent transit strike.

Thing is: living in a big city that is an island with few bridges and tunnels there is no way I could bug out. Also I don't think anyone in EMS and Fire would leave. I'm about 10 min walk from first hospital that would accept my shield for work and in case of emergency I would report there, jump on the ambulance until I can meet my home unit or supervisor. Also if not needed I can stay at JFK Airport and work there which if stranded would be a center of people dropping left and right due to their medical condition.

I think that staying behind is a better option than bugging out in my case. Hospitals/stations are set up to provide for us for extended period of time and I would do more good in the "hot zone" than out there.

It is more of the ethical thing I guess. I think you have to make a choice between: it's my job and I will do it vs I ain't getting paid enough for that.

Thanks, guys. What I was really looking for was legal ramifications though.

Around here, pretty much everything is volunteer organizations. I've unfortuantely met a few "volunteers" who I would describe as a b*****d cowards. They love to show up on scenes, but oddly none of them are the first to sign on and never if it is a scary scene. One in particular, I KNOW he drove past a car accident without stopping, I just can't prove it in a court of law. I know becuase I had pulled over already and recognized his rather distictive hunk of junk car. He's the kind of guy who buys his own kit bag, complete with O2 bottle, and carries it everywhere, even in the grocery store. He's the worst of the lot, but too many of them are what I've called "rescue studs". I was wondering if there was something that could be done to them if they bugged out and said to heck with the community.

And I know that warm bodies are critical. I'm also pretty sure that a warm body that shows up to play in the exercises but never gets their hands dirty is probably worse than an empty file.

I would address the issue with the chief officer of the company to which this individual belongs and find out what their SOG/SOP (if they have one) states regarding responding/stopping in one’s personal vehicle at the scene of an incident.

Legally (state/local laws), it may be a gray area, as “duty to perform” may refer to an individual actually on duty. Various volunteer jurisdictions may interpret “on duty” to mean only when the individual is signed up to ride or actually at the station, others may consider it 24/7.

I function on three levels, Fire Fighter, Technical Rescue Specialist and ALS Provider. All three as a volunteer, I do not respond to many fires now a days, as there tends to be a substantial number of responders and unless there is a page for all available FFs, I keep a low profile. As a member (24/7) of the technical rescue team, I respond to all calls, as our team is limited in the number members and response by all available personal is always necessary. On the EMS side, unless I am riding on the Medic Unit as an ALS provider, my stopping at an accident scene, would be to provide BLS, since we are not permitted to carry any ALS equipment in our personal vehicles, doing so would likely result in lost of one’s license (which has happened). If I come across an accident scene, my stopping to help is dependant upon what units are the scene. If there is already a full assignment I will generally not stop, unless it is obvious it is a major incident and additional assistance is required.

Pete

Pete, I hope I didn't make it sound like not responding to all calls is a bad thing. It isn't, you are only human.

As fothe other suggestions, thanks.

No, not at all.

In my experience many volunteer companies generally have SOGs/SOPs on response. Several of the companies, in our county require members to respond to the fire station and not directly to the scene. This ensures the equipment gets out, controls the amount of on-scene traffic and prevents freelancing. Other companies allow members to respond directly to the scene, so if one is near or passing by the incident stopping at the scene is permitted.

Since our ATR Team’s vehicle only holds two and our area of coverage is the entire county plus surrounding jurisdictions, we are encouraged to respond directly to the scene/staging.

Many of the companies in our county are a combination career/volunteer, responding to all calls is not as critical as those areas, which have only volunteers. As our city (Frederick which is now the second largest incorporated city in Maryland) and county have grown, many of the newer individuals and families moving into the area, do not have the same connection as long time residents and tend not join the local Fire Departments, so many of the companies have had to request supplementation with career staff. This is normal and expected as the number of calls has increased and the number of volunteers has remained relatively the same. ALS which used to be 100% volunteer is now less then 5% volunteer, due in part to the volume of calls, the need to maintain proficiency/continuing education and the length of training required to become ALS licensed.

Pete

I work as a Paramedic and EMS instructor for a living. I'm getting paid for saving lives. I also volunteer with a local EMS organization helping community and new EMTs. Only few states have the law that makes it mandatory for EMS professional to stop at the scene and render care. I think in NYC the only way you are obligated to render care is if you are in your uniform or your car has First Responder markings but all those rules go out the window if you are a volunteer. Based on my NYC experience there is nothing you can do about the gentleman (EMT/Paramedic) who passed the scene and didn’t provide care. It happens here everyday and it is a reason for high tension between some agencies. I’m talking about Hatzalah Jewish Volunteer Ambulance which is very selective in their assignments and is known to treat non-critical pts who are of certain faith prior to critical pts who aren’t. Or bypass accidents that involve a creamed delivery man all over the intersection because he was Chinese. EMS community who tries to raise complaints is always told to drop them and nobody was ever successful. As a matter of fact certain “first responders” happen to try to pull you over with their cars and still there is nothing that can be done. Happened to me and I got PD involved and the minute they heard “discrimination” only warning was issued while somebody else would get few months in jail for impersonation.

Also reason why people don’t get involved is liability. We live in the era where everyone is happy to sue somebody. And to be honest I will be more than happy to pull over and render care to seriously injured/ill but I stay away from bs. Also you have to remember that EMS is a job and you are not a paramedic 24/7. There is life outside your work. If agency that is responsible for your area has unit in service and you are off let others do their work and you go about your normal life. If I wanted to pull over and render care every time I go out I would never get anywhere because there is about 2 car accidents I pass everyday. But than again people say that if it was your family you would want somebody there asap. Yes it’s true but you have to draw a line somewhere and let others do their job. What I wrote applies in the big system and place like NYC. Other places may be different especially if they are volunteer only. Also above doesn’t apply during disasters. When Winnies Poo starts flying we all get to play with Eyore and Pigglet whenever we like it or not .

In short if you know the guy, walk up to him and say what you really think. It hurts more when you tell somebody the truth face to face than if you bring legal system into action. Probably the best to follow “duty to act” story is what happened to New Orleans PD during Katrina and disciplinary action being taken against those who left.

I'm at the hospital for my shift whenever there's a hurricane in the neighborhood (except Andrew as I was a student nurse and told to stay home)

I have been able to make it home after my shift without too much problems, and available to my family.

Just planning ahead, just in case.

I was thinking of my family specifically, and just to stave off dehydration if there something preventing us from getting in to the doc's.

If there's blood loss that would require IV fluids, that's a different ballgame and we're in-bound to the ER come hell or highwater.

Thanks Arney,

I am adding Gatorade powder to my hurricane box inventory.

Would something like Pedialyte be better? Many brands, plus I am almost certain that this sort of thing can be found powdered. Not supposed to exclusively use electrolyte solutions for re-hydration over long period, but it's just the ticket for starting re-hydration. IMHO, these are far better - especially for infants and kids - than a sports drink.

Edit: Here's an example - Gookinaid Hydralyte - it's powdered and claims to be even faster than Pedialyte. Caveat Emptor, of course, but this sounds better than GatorAid.

HTH,

Tom

I would agree that if you're concerned about a situation like vomiting and diarrhea, there are better things out there than Gatorade, and you can even use stuff you find at home to mix up your own rehydration solution. If you didn't see it already, we had a discussion a few weeks ago on the topic here.