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Suddenly realized that I have a character that's going to be in the hospital for a bit. Among other sundry injuries, *both* arms are broken. And from what I recall from when had my arm broken, the initial cast will cover the elbow.
Anybody know where they stick the IV in such cases?
Actually...
Actually, modern medicine using places IVs on the top of the hands.
If you have to prevent the
If you have to prevent the person from rotating their forearm (as was the case both times I broke my arm) the back of the hand is under the cast. Which is why I'm wondering.
My poor character had both arms *stomped* against the (concrete) stairs they were laying on (part of a nasty "gay"-bashing). And that's only some of the injuries.
I figure first a "beat down", then the stomping. Fortunately the bad guys get interrupted. Also, fortunately it's a Whateley-verse story and the character "triggers". So the prognosis is better than in our world.
Brooke brooke at shadowgard dot com
http://brooke.shadowgard.com/
Girls will be boys, and boys will be girls
It's a mixed up, muddled up, shook up world
"Lola", the Kinks
Broken Arms
Hi a few years ago I was in hospital with the same problem as your character I had the canula for the IV in the back of my hand as the cast only came down to my wrist.
Christina
Back of the hand
Yep, somewhere really inconvenient.
I didn't have broken bones but had a cannula and a drip before I even had a chance to take my clothes off!
Over seven days I had one in the left hand, then the right, then back to the left when the previous one didn't work properly.
Problem is, it is next to impossible to keep yourself clean with that sticking out of your hand. Washing? Shaving? Toilet paper? Yuk.
On a subsequent visit to hospital, when they thought I had Swine Flu (I didn't) the cannula went into my right elbow. Of course, the moment I bent the elbow, the drip stopped feeding...
Penny
With both arms in casts, you
With both arms in casts, you aren't gonna be wiping. Or doing your own washing. I'm just lucky that both times I've broken my arm, it was my left arm.
Brooke brooke at shadowgard dot com
http://brooke.shadowgard.com/
Girls will be boys, and boys will be girls
It's a mixed up, muddled up, shook up world
"Lola", the Kinks
Chances are
Chances are, that if the hospital can not use either arm, they will start a subclavian IV. (That is under the collar bone.)
IVs
Well, the positions wanted for an IV:
Peripherally: PVC locales: back of hand, underarm, wrist (lower risk of nerve damage, less tendency of veins to roll away, not as much inconvenience when moving arm for awake patients compared to elbow), inside elbow. During operations but pretty much no other time, back of feet or lower leg veins may be used.
Centrally: CVC locales: Generally we have three veins for use here, v. jugularis int. (neck, typically used in ER and OR), v. subclavia (below the collarbone, typically used for longer perspective use), v. femoralis (groin, seldom used unless operations make the other localisations unsuitable).
There's also the possibility of peripherally inserted central catheters, PICC, usually through v. basilica on the upper arm.
And yet another long perspective option is subcutaneous vein ports, in v. jugularis int., v. subclavia or in v. cephalica, which are basically a more permanent variant where a small box in plastic or metal is placed under the skin, and you can get vein access through this with a normal needle through a membrane in the box.
IV locations
As others have pointed out, a PICC or central line would need to be used if neither arm was available. Also available for use would be an external jugular vein, or a vein on the dorsal side of either foot.
Just got out of the hospital
I just got out of the hospital and I can tell you from experience that there are other places for an IV. I have congestive heart failure and had my difibulator go off thee times in one day, not good. I was admitted to the hospital and stayed for almost a week. During the visit I accidently pulled my IV out of my hand during the night, which evolved into a staph infection, but that's another story. I have very poor circulation and they ended putting the IV in my shoulder for the last two days of my stay. I hope this helps, Arecee
Medical
It all depends on a number of things
How far up or down the cast extends
Age of the casualty
vein or artery structure
How accessable the blood vessels are
I've known IV's to be inserted in the ankle on a couple of occassions
Generally
A forearm break is usually either nearer the wrist or nearer the elbow; not that many breaks require immobilizing both ends of the forearm, so either the back of the hand or the inside of the elbow would likely be available. But there are other places, as have been mentioned, sub-clavian (high on chest), cervical (neck) or femoral (thigh) might be used depending on other injuries and state of the patient. Foot, armpit and groin have been used in some really odd situations.
Hugs,
Erin
= Give everyone the benefit of the doubt because certainty is a fragile thing that can be shattered by one overlooked fact.
It depends...
For me, it would likely be my chest... But then, I have a port...
as the others said
Just about anywhere you can get to a vein. At the ER there are a lot more options. You can cut open the skin to access a vein directly if necessary. Way back when not getting a stick in the back of a moving ambulance was not an option during a life or death situation and you tried everywhere. You get to the point of assessing people you see as to how many tries it would take to get a good stick. If it's not life or death we were supposed to be restricted to four attempts in the ambulance and let the ER do it.