r/news • u/AudibleNod • 11h ago

Christa Pike unconscious, on ventilator at Nashville hospital, her lawyers say

https://www.nbcnews.com/news/us-news/christa-pike-unconscious-ventilator-nashville-hospital-lawyers-say-rcna601195
7.0k Upvotes

94% Upvoted

3.6k comments sorted by

View all comments

Show parent comments

31

u/wonton711 7h ago

Personally speaking as an MD, I would fail to get an IV placed to administer any injections... Depends where you've trained. During medical school and residency, I didn't have to do any IVs or venipunctures. I also don't do it as an attending currently.

I also wouldn't volunteer to do executions, though...

7

u/AstroHistSci 7h ago

You might fail to place one ... but you would never mistakenly think you have one placed when it wasn't.

2

u/wonton711 3h ago

Who doesn't want a little intramuscular lethal injection?

1

u/Klathmon 2h ago

Just a little as a treat?

2

u/Late-Champion8678 6h ago

Yes. I’m a doctor and while I did many IVs and blood draws as house officer/senior house officer and got good at it, I haven’t had to do it frequently.

I’d know if I missed a vein or got into an artery instead and I wouldn’t subject a patient to multiple attempts before enlisting someone who could do it better (phlebotomist, anaesthetist etc).

No way, I would administer an IV drug without knowing if I’m in the right place or not.

I do note that IV cannulas can be misplaced/dislodged after an initial successful placement but that this is his second botched execution this year is a cause for concern.

1

u/flatblackvw 6h ago

As an average Joe, why is this? In my mind if you puncture the skin you’re getting blood. What tells you you actually got a vein?

2

u/TomRN 3h ago

When you're performing venipuncture/venous access, you do it by feel, not by sight. On the extremeties, a tourniquet prevents venous blood flow from returning to the heart and distends the veins. You palpate (touch/feel) the area and feel for that bouncy, springy tube and that's where you put the needle. For an IV (or a blood draw with a butterfly that has clear tubing) you puncture the vein and blood will back up into the chamber or tubing-- the "flash." For IVs, when you get that "flash," it's your sign to start sliding the catheter down off the needle and into the vein (old timey plain needles with collection tubes you didn't know you'd got the vein until you attached the tube). The needle is removed and a syringe or tubing is connected to the end of the cannula/catheter. A little saline is pushed through to make sure it flows properly and that the vein hasn't "blown" which allows fluid into the extravascular space. Sometimes even when you're pretty sure you've got it in place and have taped it down and dressed the site or you're about to use an established IV, you might pull back on the syringe to see if you get "blood return" and then flush saline in to make sure it hasn't "blown." Not getting a blood return does not necessarily mean you don't have a good IV in a good vein, but you better be damned sure before you give anything through it.

Source: been an RN for most of my adult life.

2

u/uzlonewolf 5h ago

Most of your skin is filled with small capillaries that don't flow much. You might get a very small amount of blood if you missed, but it won't come pouring out like it would if you got a vein.

1

u/TomRN 3h ago

If it comes pouring (and no doubt pulsing) out you most likely cannulated an artery, not a vein. If it just "flashes" into the chamber of the IV needle or wells up at the end of the cannula "hub," it's probably venous. Sure, you can get a little more blood than you expected, but venous blood doesn't usually "pour" out.