As road-staff, we regularly have to contend with doctors and nurses complaining about our choice of whether or not to cannulate a patient, which vein we use, or why we didn't bother at all sometimes.
Trying to explain at hospital that the patient was trapped in a car that was upside down and on fire, surrounded by a herd of elephants that were corralled by a pride of ravenous lions, which in turn were being shot at by hunters, doesn't seem to hold much water.
Strangely, therefore, sticking lines in people out in the field isn't always quite as simple as dealing with a patient in the relatively sane (I said relatively) of the hospital. Some IV's are easier than others, but until now, there has been no actual scale on which to compare and contrast the complex nature of one of the most basic aspects of our job.
However, a while back, The Happy Medic came up with one.
So as a weekend treat, I hereby attach a link to a "difficulty scale" for sticking needles in people.
It includes bonus points if the lighting is less than ideal, if you're hanging upside down, and various other "normal" variants to the tricks we must employ to do what in theory is a very simple task.
Simple, if your patient is four feet off the ground and horizontal in a well-lit hospital bed, and with several pairs of hands to do everything else, that is.
5 comments:
Well said sir and so true
our trust has stopped the "cannulate everyone just in case" idea & only expect cannulation if clinically required. This has upset some A & E staff who have complained to the trust. We have been told to report every time hospital staff complain about not cannulating before arrival at A & E
Oh so very true, hospital staff seem to be so out of touch with the prehospital world its mental.
But then again ive seen people try and fail to cannulate well hydrated patients, lying supine, on a trolley with lots of help....after 4 or 5 goes.
Dont worry IM I'll always fight the pre-hospital crews corner....have done before, why stop now
Have to agree with all of this. But, I would go further. The number of patients in my A&E who are cannulated just because they are in a Majors cubicle is ridiculous. A 30 year old with indigestion. OK, it might be a heart attack, but who are you kidding? You just like sticking needles in people!
In my experience road staff are a hell of a lot better at it too.
I've been cannulated in the back of a moving vehicle, while quite poorly and not particularly well hydrated, first time, no bother! Its taken a doc 11 goes to do it while well, and well hydrated, sitting up in a well lit day unit! go figure.....
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