Quite possibly a stupid question

T

Taffd

Guest
#1
In emergencies, where a saline drip would be the optimal choice but unavailable, could ordinary water be used instead?
 
#2
There's probably an osmosis reason saline is used as opposed to pure water, otherwise it'd be a pure water drip, not that I'm a medic.

Maybe repost in the PQO forum as you may snag a Dr or Nurse type.
 
#3
My Mrs (Doctor Wobbly) told me recently that in an emergency coconut water can be used as a substitute for saline. Apparently when it's inside the coconut it's sterile and has the correct ph. I had to google to check it wasn't utter bollocks and apparently it's true.
 
#4
In emergencies, where a saline drip would be the optimal choice but unavailable, could ordinary water be used instead?
Don't know, I'm by no means a medic but I think if you put pure water in then you there's the chance you could tip the osmotic balance between the intracellular and extracellular fluid. Water could move in to the cells, in this case the red blood cells and make them go pop. The increase in potassium from haemolysis might lead to cardiac arrest. It might also be possible you could "force" fluid into the brain causing it to swell.

Might be talking total bollocks mind, just going from a very limited knowledge.
 

Fang_Farrier

LE
Kit Reviewer
Book Reviewer
#6
There are several aspects to this, sterility of the water to be one, there is also the issue of why fluid replacement is required in the first place.
Unlikely to cause blood cells to "pop" as would need a few units of water to create enough dilution but basically it would effect the blood chemistry fairly significantly and due to the osmotic reaction would draw various chemicals outs of the cells into the blood, which would effect the functioning of vital organs.

However there is a place for sterile water in medicine, I regularly use it in surgery, washing out under flaps, using to to cool drills used on bone, but in these instances it is not directly introduced into the blood stream and most of it is aspirated away by my assistant.
 
T

Taffd

Guest
#7
I was thinking of a battle type scenario. Medic not avilable with drip, severe loss of blood and need to increase blood volume.

If for example a suitable sachet of salts was carried by all soldiers, could it be added to water that they carried, and used to save life.

I suppose the question could have been - Is it possible to make an emergency drip with one's water ration and a 'suitable' sachet of salts?
 

Fang_Farrier

LE
Kit Reviewer
Book Reviewer
#8
I was thinking of a battle type scenario. Medic not avilable with drip, severe loss of blood and need to increase blood volume.

If for example a suitable sachet of salts was carried by all soldiers, could it be added to water that they carried, and used to save life.

I suppose the question could have been - Is it possible to make an emergency drip with one's water ration and a 'suitable' sachet of salts?

How would you deliver it would be next question?

Easiest way may be through enema route, that way would avoid nil by mouth, as that increases risks during future surgery/anaesthesia.
 
T

Taffd

Guest
#9
How would you deliver it would be next question?

Easiest way may be through enema route, that way would avoid nil by mouth, as that increases risks during future surgery/anaesthesia.
Assuming the idea worked could soldiers regularly carry a sachet plus 'drip-feeding apparatus' as standard. A slight increase in weight I accept, but would the potential benefit outweigh the negatives?
 
#10
Its hard enough getting a line in under hospital conditions, adding a battle, panic and a soldier who has been shown a couple of times how to do it will probably lead to lots of holes, no fluid going in and a delay in life saving first aid.

I do see where you are coming from though, but generally, if someone is needing fluied that urgently that they cannot wait for the medic whilst there buddies stem the flow of blood, then they are probably too full of holes to make any difference.
 
#11
Its hard enough getting a line in under hospital conditions, adding a battle, panic and a soldier who has been shown a couple of times how to do it will probably lead to lots of holes, no fluid going in and a delay in life saving first aid.

I do see where you are coming from though, but generally, if someone is needing fluied that urgently that they cannot wait for the medic whilst there buddies stem the flow of blood, then they are probably too full of holes to make any difference.
I may be wrong, but didn't all soldiers in the Falklands carry saline & giving sets? I remember reading that the enema option was taught because the cold (and presumably shock) would make IV very difficult.
 
T

Taffd

Guest
#12
I seem to remember a book where SF types inserted their own cannulas before an op.

Not sure how feasible it'd be in real life.
 

Fang_Farrier

LE
Kit Reviewer
Book Reviewer
#13
I seem to remember a book where SF types inserted their own cannulas before an op.

Not sure how feasible it'd be in real life.
Sod's law would say that where ever one places the canula that's where the innury will occur!
 
#14
I may be wrong, but didn't all soldiers in the Falklands carry saline & giving sets? I remember reading that the enema option was taught because the cold (and presumably shock) would make IV very difficult.
Mid 1980's I knew someone who worked for ICI. He told me they had developed the enema version, could be used by anyone, no particular skill or training required. So you could be right.
 
#15
I may be wrong, but didn't all soldiers in the Falklands carry saline & giving sets? I remember reading that the enema option was taught because the cold (and presumably shock) would make IV very difficult.
That's correct, the cold also stopped a lot of the wounded from bleeding to death
 
#16
As stated, you would further compromise the electrolyte balance. If you had a giving set , you could consider delivering it rectally but the absorbtion rate is not as quick as IV. There are so many variables in this. It's not as simple as saying, he has lost blood, I must deliver hoofing amounts of fluid. The first clot is the best clot. You could find that by over infusing, you displace the clot, compromise any clotting factors and then find that the casualty bleeds out. A good indicator, is that if there is a radial pulse, the vital organs are being perfused.

Auto infusion, i.e raising the casualties legs(injuries permitting) is another option.

Unfortunately, if the casualty has lost that much fluid. you are going to have other issues.

It basically comes down to oxygenation. Delivering 100% O2,stopping the bleeding and rapid casevac would be better than filling the guys hoop with water.
 
#18
My Mrs (Doctor Wobbly) told me recently that in an emergency coconut water can be used as a substitute for saline. Apparently when it's inside the coconut it's sterile and has the correct ph. I had to google to check it wasn't utter bollocks and apparently it's true.
By a strange coincidence I was watching bush Tucker man last night. In the show he states that the use of coconut water is quite common in the Solomon Islands as a drip solution.
 

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