Lack of i-v expertise puts patients at risk.

Thousands of patients are dying from incorrect use of IV drips, warns Nice.

They go on to say (source, the Guardian, today), that “Patients’ lives are being put at risk by an “astonishing” lack of knowledge surrounding the correct administration of intravenous (IV) drips in hospitals in England and Wales…”

I’m not surprised.

During my recent 10-day stint  in hospital, I was on the receiving end of i-v Vancomycin, an antibiotic, at the rate of 250ml 3 (or 4 – there seemed to be some uncertainty), times a day for a week.

This was screwed up so often that I wound up with not a single useable vein left in my hands or arms. Most have now recovered, to a greater or lesser degree (though I won’t know for sure if they have until the next time someone tries to get blood), though one remains blocked.

The thing is, though, nobody had the slightest idea of the timing for delivery of the i-v, which ranged from 20 minutes (painful), to an extremely trying 2 hours (being shackled to an i-v when also suffering from diarrhoea is not fun, especially when witless staff put the i-v stand on the opposite side of the room to the commode!).

In the end, mainly because of the damage to my veins, I called a halt, refusing any more i-vs and restricting the taking of blood to one attempt – which invariably failed.

It seems, based on what NICE say, that I had a lucky escape. Rest assured that, should I be unlucky enough to be admitted to hospital again, the administration of i-v drugs will not be permitted. That decision is partly based on this report, which just reinforces my original gut feeling that the buggers hadn’t the remotest idea what the hell they were doing, and just making it up as they went along, to my considerable detriment.

4 thoughts on “Lack of i-v expertise puts patients at risk.

    • I just wish that many more patients had the knowledge – and the will – to challenge their doctors if it’s necessary, and not just unquestioningly accept everything that’s dished out. They won’t be popular, but they might just live longer and/or escape injury.

      I was told there was no oral alternative to the i-v (true, oral Vancomycin is useless – bioavailablity is close to zero), but when I refused the i-v they quickly came up with an oral alternative!

  1. Slightly off topic but thought I’d mention it…..

    My veins have been wrecked over the years from illness and the relentless stabby hunting for a working vein which would invariably collapse as soon as the needle went in, or would collapse a few minutes after the drugs/saline started flowing.

    The solution for chemo (where extravasation can be lethal) was a Hickman Line (AKA central tunnelled Groshong line). It was brilliant and meant the days of sitting with my hands in bowls of hot water listening to the tutting and sighing of whoever was fruitlessly trying to find a vein and being stuck 53 times a day were over. I was a tiny bit sad to have the line removed because it made such a positive difference to my treatment. I know one woman who has had the same line in for 3 years with no plans to take it out. The procedure took about 45 minutes with local anaesthetic (and some midazolam) and settled down quickly.

    You have to lie still with your head turned away so that the vein they are inserting the line into in your chest is raised and accessible.

    With the MRSA issue, it might not be possible for you to have one or appropriate. I chose to have one because the alternative (a PICC line in the inside edge of my upper arm) would leave me unable to do weekly line care myself and it would have got in the way of everything from bathing, dressing and sleeping to even sitting reading or cooking. I met lots of women with PICC lines who loathed having them, found them painful and a pain!

    The Hickman line is discreet too. A simple waterproof dressing et voila, showering and bathing are possible without a big fuss. With PICC lines you can’t get them wet and have to wear expensive and very uncomfortable waterproof sleeves to bathe. Not for me at all.

    The type of line I had, had a valve in the end port so that no air can get in when the line is flushed, It was a neat solution and just made everything about treatment much easier. Medicine went in, bloods could come out when needed and I didn’t need to attend the clinic or my GP weekly for line care.


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