Anonymous wrote:The other night, we had 6 people try to start an IV in a dehydrated patient. All good sticks....we could hit the vein, but the pt was so dry they wouldn't thread.

Not everyone has good veins. And I hope you aren't even a tiny bit overweight, or possibly edematous d/t the end of your pregnancy: Both situations obscure veins.

Anonymous wrote:For all of those who don't want to get a saline lock in the hospital, you'd better also not want an epidural. None of you want one, right? Besides the fact that they have to bolus fluids in you before the epidural (via IV), they will also be sticking a needle in your SPINAL CORD, which is a helluva lot more invasive that a peripheral vein.

So, none of you want an epidural, right?

Anonymous wrote:So, none of you want an epidural, right?

Anonymous wrote:For all of those who don't want to get a saline lock in the hospital, you'd better also not want an epidural. None of you want one, right? Besides the fact that they have to bolus fluids in you before the epidural (via IV), they will also be sticking a needle in your SPINAL CORD, which is a helluva lot more invasive that a peripheral vein.

So, none of you want an epidural, right?

Anonymous wrote:I'm sitting here and find all this talk of how difficult it can be to place an IV in someone in an emergency, and I just don't get it. Maybe I was lucky. Maybe I had the world's best IV placer. I was in a pretty nasty car crash, all sorts of broken and dislocated bones, bleeding, concussion, shock. One of the few things I remember is this amazingly deft insertion of the IV (ever try and start an IV on a needle-phobe who is thrashing and not really aware of what's going on?), like it was no problem. My friend, who walked away from the accident, saw it and marveled at the ease in which they were able to do it.

Anyways, I figured if they can get an IV into me when I'm thrashing about and trying to scream "NO!" despite the fractured and dislocated jaw and trying to swat the nurse away with an arm that's at a funny angle, you can get an IV into pretty much anyone.

And now I hear abut how bloody hard it is to insert IVs and that's why I need that damnable not-hep heplock in my arm....well, you see why I'm wondering just what the heck is going on here.

Anonymous wrote:

Anyway, I just don't see what the BFD it is to put a f-in iv in your arm. Are people going to start requesting the type of stitch that goes in their hoo-ha when they get a 2nd degree tear?

Anonymous wrote:Can we once and for all agree that there is NO HEPARIN instilled in the IV? HEP LOCK is an outdated term. NOONE following current practice guidelines puts heparin into peripheral IVs.

Anyway, I just don't see what the BFD it is to put a f-in iv in your arm. Are people going to start requesting the type of stitch that goes in their hoo-ha when they get a 2nd degree tear?

Anonymous wrote:

Anonymous wrote:"Heplock" is an outdated term medical professionals still use. I've been a nurse for 20 years and haven't put heparin in a peripheral IV for 17 of those 20 years.

I imagine the reason for putting an IV in upon admission does make it easier because if the delivery isn't progressing as it should, the IV is one less step to worry about. Just because you normally have 'good veins' doesn't mean you will during a difficult labor. The body can clamp down, veins collapse and perhaps there isn't a person who can put an IV in very well.

If it was me, I'd want the iv in as an insurance policy. One less thing to worry about because in an emergency, you'll need that IV and not having it in means there's a delay in intervention. That delay could be 15 minutes. Precious precious time.

Honest question -- did you work L&D? If so, how often did you see such a situation? And I mean, a situation where there were absolutely no other indications that there were any problems, where the mother was 100% unmedicated, where everything was progressing completely normally, and then within a matter of minutes, the mother was in such a state that her veins were collapsed and unable to be accessed? Yes, I understand there are emergency situations - especially when risk factors are already present - but in all my years attending homebirths, we have never, not once, encountered this specific situation. There are always some indications which then call for IV access -- so we always have IV access before it becomes an emergency. Even in the absolute worst hemorrhage I've ever seen, there was time to start an IV because we were paying attention and caught the warning signs just as it started.


Regardless, women should and do have the right to take any risk they want to with their own body. As long as her baby is still inside, she holds that power. No protocol should trump what she wants, period. This includes women who want elective c/s - yes, it is riskier for both her own and her baby's body (and of course any future babies she carries) yet still, if she can afford it, it is her right. We should not be scaring women into submission.

Anonymous wrote:I'm sitting here and find all this talk of how difficult it can be to place an IV in someone in an emergency, and I just don't get it. Maybe I was lucky. Maybe I had the world's best IV placer. I was in a pretty nasty car crash, all sorts of broken and dislocated bones, bleeding, concussion, shock. One of the few things I remember is this amazingly deft insertion of the IV (ever try and start an IV on a needle-phobe who is thrashing and not really aware of what's going on?), like it was no problem. My friend, who walked away from the accident, saw it and marveled at the ease in which they were able to do it.

Anyways, I figured if they can get an IV into me when I'm thrashing about and trying to scream "NO!" despite the fractured and dislocated jaw and trying to swat the nurse away with an arm that's at a funny angle, you can get an IV into pretty much anyone.

And now I hear abut how bloody hard it is to insert IVs and that's why I need that damnable not-hep heplock in my arm....well, you see why I'm wondering just what the heck is going on here.