IV fluids for stroke pt's

[HERBIE1]

I am not a big fan of starting saline locks only on CVA patients, especially if they are neurosurgical patients & going to be going to the OR. I can tell you from experience that during neurosurgical cases for cerebral aneurysms that they will sometimes induce moderate hypothermia by rapidly infusing IV fluids for cerebral protection.

Why would a saline lock prevent pushing fluids?

[Kiwiology]

Why would a saline lock prevent pushing fluids?

It would not. Perhaps our friend works in one of the backward ass systems I have heard of who do not use saline or hep locks and run a bag of fluid whenver they start an IV.

You know the old ambo trick of "more is better" has a perfect application here, not.

[HERBIE1]

It would not. Perhaps our friend works in one of the backward ass systems I have heard of who do not use saline or hep locks and run a bag of fluid whenver they start an IV.

You know the old ambo trick of "more is better" has a perfect application here, not.

The only reason we went to saline locks was pure economics. A few cc's of flush an angiocatheter, and a J-loop are still a lot cheaper than a bag of saline and tubing. Unless someone needs fluid replacement, having IV access via a lock is all we need. If for some reason things change, hanging a bag is no big deal.

[emtannie]

I am a little confused..

Like Herbie, I am wondering why a lock would prevent providing IV fluids once in hospital. Our locks are "Interlink" so you can attach an IV line instantly without having to start a new IV.

I agree with other posters who have said that IV fluids in a stroke patient are not needed; in the case of the original poster, there appears to be no immediate need for additional fluids, so I think it was a good call not to IV. I would have started a lock so that IV access is already available when the hospital needs it.

Good thread!

[tskstorm]

I am a little confused..

Like Herbie, I am wondering why a lock would prevent providing IV fluids once in hospital. Our locks are "Interlink" so you can attach an IV line instantly without having to start a new IV.

I agree with other posters who have said that IV fluids in a stroke patient are not needed; in the case of the original poster, there appears to be no immediate need for additional fluids, so I think it was a good call not to IV. I would have started a lock so that IV access is already available when the hospital needs it.

Good thread!

Thanks, for the patient I specifically mentioned to begin with an IV S/L was established.

[Kiwiology]

I've heard around some hospital systems will remove field IVs and start thier own; although I've never seen this myself.

[tskstorm]

I've heard around some hospital systems will remove field IVs and start thier own; although I've never seen this myself.

Depends on the hospital around here, however most of the time, they will only remove a patent IV if you started B/l IV's ... because they need to draw blood and they prefer to start a new IV then use a butterfly ... I don't know why.

[Arizonaffcep]

During transport I looked at my partner, and said, want to give her some fluids as well? He asked a great question, why? My only answer was, I remember someone(I don't remember who) saying to do so, but the physiology behind it was a mystery, so we skipped the fluids.

Ok...so I haven't posted on here in like...a year or more shame on me. Do damned busy. Only words of wisdom I might have regarding fluids bolus with suspected CVA is an OBVIOUS Cushings Triad, where their MAP would need to be adjusted. But...that's rare and WAY late in the bleed. Only time I can think of.

[Mateo_1387]

It would not. Perhaps our friend works in one of the backward ass systems I have heard of who do not use saline or hep locks and run a bag of fluid whenver they start an IV.

You know the old ambo trick of "more is better" has a perfect application here, not.

That is quite a jump to a conclusion about which type of ambulance service he/she works with. In retrospect, I read the post twice and thought maybe the poster wanted to portray that if a patient is going to be going to the operating room immediately, then he prepares Normal Saline ready for use by the hospital staff. The poster did not state that IV fluids are used with every IV.

[emtannie]

Thanks, for the patient I specifically mentioned to begin with an IV S/L was established.

Tsk, I was referring to the post by 1-EMT-P where they indicated that they wouldn't use a lock:

1EMT-P, on 16 January 2010 - 08:37 AM, said:

"I am not a big fan of starting saline locks only on CVA patients, especially if they are neurosurgical patients & going to be going to the OR. I can tell you from experience that during neurosurgical cases for cerebral aneurysms that they will sometimes induce moderate hypothermia by rapidly infusing IV fluids for cerebral protection."

(I should have used "reply" on my other post, so that it would have made more sense - sorry)

So, I am still wondering: Like Herbie, I am wondering why a lock would prevent providing IV fluids once in hospital.