View Full Version : Buck Rogers Dept #3 - in-situ IV fluids
Stern's Outdoors - http://www.sternsinc.com makes a high flow, ceramic water filter that looks a lot like a plastic IV bag, but with a handle and a place to add fluids like on a cammleback or a hydrastorm. THe ceramic filter will deliver 15L an hr and filters to 0.5 microns. A secondary filter might be needed prior to going into a vein...
wouldn't you rather just carry the empty bag and filter than a couple of liters of IV fluid? (carry some salt too...)
Reasonable Rascal
02-21-02, 00:16
I don't believe 0.5 microns is going to be fine enough filtration for IV use. Anthrax spores are smaller than that and they are relatively speaking somewhat large on the germ scale.
RR
Tell Johnny to drink water. If he is so bad off that he can't, he probably needs more than just filtered (not even purified) water pumping into his veins.
Dan
note about salt was to imply making NS....
Reasonable Rascal
02-21-02, 00:49
I caught that reference, but we are talking fairly precise measuring here, the issue of sterility, etc aside. If the situation is bad enough you'd consider resorting to this you wouldn't be able to more than guess at the salt, even if you premeasured, because you may well have an inherent saline level in the water you were using, though granted low unless we are talking sea water or saltmarsh brine. But that alone could be enough to upset the osmolarity balance within the body.
RR
I doubt the % is that critical... but I could be wrong. salinity, that is. THe main objection w/ field IV fluids is getting them sterile enough. this still seems to hold promice, im my mind, ad the weight gain is substantial over what you'd have to pack - also you would not be limited to what you could pack!!!!!! secondary filter - sure...
RESQDOC wrote:
8. Regarding using a purifier to generate “usable” if not perfect solutions, I think this would be an excellent method for generating fluid for PROCTOCLYSIS but I would prefer other means for intravenous or hypodermoclysis. For those of you unfamiliar with the concepts of osmolarility, tonicity, RBC crenation and herniation, look them up. For those of you who understand these already, the problem is of course obvious. I believe that sterile water is acceptable for the rectal route, although a roughly isotonic solution would be better. The risk here of course is that you would screw up and generate an excessively hypertonic solution and worsen the dehydration rather than correct it. We often use solutions of variable tonicity for intravenous infusion, within limits, such as ¼ and ½ normal saline, D5W, etc. so a little variability is acceptable but being grossly off is not. And of course there is the entirely different problem of infection control. I think that distillation is the better course for intravenous fluid generation. Remember one of my favorite sayings, “Necessity is a mother.”
I'm getting serious "write this off" "vibes" from people on this topic - lets *NOT!*
this ties into several other threads - in particular the one on SQ rehydration, there a saline solution was boiled and administered SQ. Very rough measurements, very field oriented. Others are the posts on making IV and irrigation fluids in the pharmacy.
Q's:
1) why is it really necessary to distill water pre-use?
2) how much is the saline content going to vary w/ water obtained in the field (not sea water)?
3) is this REALLY clinically significant?
note: FEMA method of distilling water by inverting a pot lid on a pot and suspending a tea cup under that to catch runoff from the handle - like a solar still, also the hot water heater used by some DMAT teams that is basically a condenser tied into a veichle(sp?) cooling system.
OK - so maybe the idea is impractical, but by teasing out where it breaks down and what extra steps are REALLY needed, we could improve other processes. Next to an 02 tank, IV fluids are the heaviest bit of kit a medic has to cary, and getting that weight down, expecially in a way that makes the number of IV's that can be administered to unlimited (virtually), is *SIGNIFICANT!*
FLIPPER! - if my spelling didn't pull enough torr, my typo's do....
are u seeing where I'm going with this?
PLEASE! - we've been asking for MONTHS! - get a spell checker on this site!
Tangent,
Dont get put off on this thread. Its an excellent one. I see making IV solutions in the same light as canning and envisage a similar process. Ive managed to collect a dozen old NS bottles from the early 70's, and have them stored away. I had a play around 12 months ago. Managed to make almost perfect N.S - very slightly hyertonic, and the micro lab at work couldnt grow any bugs from the solution either immediately or at 2 weeks. It can be done ! Mind you I was using distilled water and scientific grade NaCl - so cheated a little, but when I have some time Ill expand my experimentation.
Craig
Reasonable Rascal
02-21-02, 21:43
Tangent,
Au contraire mes ami. Just that running water through the filter alone is not enough for IV use, etc. Rather you have a beginning.
That's why we are here, to hash these things out. Just because filter A isn't enough doesn't mean that combined with process B and step C that we might not have something that, under austere conditions, might be worthy of consideration.
I do think that somewhere in the future though there lays the potential for just such a filtration device. Though in contrast to direct gravity filtration I suspect it lays more along the path of reverse osmosis, i.e. pressure filtration.
I must say though that the device offers promise for oral rehydration fluids. Dry electrolyte mix combined with local source water filtered through the device would save a lot of space and weight carrying pre-mixed solution and also saving canteened (is that a proper word?) water as well. Otherwise you end up using the potable water needed by others in the group, and have to start over filtering, etc for them.
As Resqdoc pointed out, it may be suitable for protoclysis. That in itself is a darn site better than "Here, drink this and let's hope it stays down this time."
RR
RL Wrote:
OK, speaking of Buck Rogers. Hypothetical scenario....the S done HTF, no Doctors in sight, brother-in-laws been shot in the leg and is getting shocky due to blood loss. I've got some 14 ga IV setups but no Ringers or Saline in-a-bag. Can I use sterile Saline solution prepared for opthamalic contact use? The specific ingredients include "an isotonic sterile aqueous solution contining a borate buffer system and sodium chloride. Preserved with 0.1% Sorbic acid and Disodium ETDA". I'm just looking for a general feel for this application, it sure is convenient.
(as I've allready been flamb'ed this week over my knowlege of neuro-anatomy, I'm going to leave this one to the docs... - moderator)
Stop the bleeding before you dilute his dissapating blood supply with fluid that will shortly be drawn into his intersticial space.
Can you tell I'm not a big fan of pushing fluids (except Hespan/Hetastarch and blood) :smile:
Dan
http://server505.hypermart.net/gogetemgear/classes/Tactical_Combat_Casualty_Care.ppt
Dan
why Hespan/Hetastarch? why favor those?
I was being too cute with the hypothetical angle. Assume the ABC's are taken care of. In any number of situations a patient might need parenteral fluids administered quickly and efficiently: hypovolemic shock, severe dehydration, or burns probably being the most common.
I've seen some interesting posts referring to a double distillation process to create IV fluids, but that is time consuming in real time and I'm not sure I could store them long term without comprimising their sterility (I currently use a pressure cooker as an autoclave :eek:)).
Mainly, I'm interested in the viability of using the Opthamalic solution in the absence of the proper fluids, strictly in an emergency.
I was being too cute with the hypothetical angle. Assume the ABC's are taken care of. In any number of situations a patient might need parenteral fluids administered quickly and efficiently: hypovolemic shock, severe dehydration, or burns probably being the most common.
I've seen some interesting posts referring to a double distillation process to create IV fluids, but that is time consuming in real time and I'm not sure I could store them long term without comprimising their sterility (I currently use a pressure cooker as an autoclave :eek:)).
Mainly, I'm interested in the viability of using the Opthamalic solution in the absence of the proper fluids, strictly in an emergency.
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