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Old 04-24-2008, 01:04 AM   #1
Jon
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IV Saline for Hangover prevention/solution


Ok folks... I'm going to raise a hot button issue here...

Growing up in EMS, and spending lots of time with medics, I've heard LOTS of stories about EMS providers using IV fluid as either prophylaxis or treatment for a hangover. When I was in Baltimore for the EMS conference, the issue came up and I heard some perspective I hadn't heard before.

Now--- the big question:

Is it appropriate for an ALS practitioner to use IV fluid to treat dehydration... specifically hangovers? Is it appropriate at work? Is it appropriate at home?

Does your agency have any policies preventing it?

WHY?





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Old 04-24-2008, 07:23 AM   #2
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i know someone who was just let go because he did this exact thing, im not sure on details, so i dont know if it was at work or at home
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Old 04-24-2008, 09:18 AM   #3
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Hm.. At work? The good side of me wants to say "shouldn't have been at work hungover!" The skell side of me wants to say "I don't see a problem with it.. as long as you take the line out of you before a call." (I've actually ridden with somebody who has had a litre of bag in him at work. He dc'd the bag before the call, but kept the line in and just put some 4" roller gauze over it and took it out during txp with a pt.

At home? Not sure.


For that ultimate hangover, some will do a "banana bag" with an amp of D50 infused into NS.

(The banana bag contains B12, thiamine(B1) and folic acid(B9), sometimes magnesium sulfate.)

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Old 04-24-2008, 10:28 AM   #4
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Is it appropriate? Yes, the pt can benefit from that.

Is it appropriate at work or at home? ( for personal use/non-transport ) No. That is called practicing medicine without the direct supervision of a physician, and if I am not mistaken, is a federal law.

We do have a policy stating that, becuase back in the 90s our medical director heard of that practice going on and he wanted to reiterate the law to us, that the practice under his license is unacceptable.

Just FYI: On most of our medical equipment, this message is posted: " Federal Law restricts this device to sale/use by or on the order of a physician."
This goes for any oxygen device, IV fluids, ashman chest seal, etc.... that bears that label.

Do I agree with it? Not always. But running the risk of loosing my license for starting an IV in a hung over friend just because he could not control his drinking habits.... naaaaa. Not me. He/she may feel like dying, but he wil be just fine.

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Old 04-24-2008, 10:51 AM   #5
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Is it appropriate for a pt on a call? Yes. LR's better than saline.

Is it appropriate for a coworker not on a call? Hell no. If you show up for work and "pee hot", you go home along with your partner who's trying to help you cover it up. And make sure both of your CV's are up to date while your there. You should have plenty of time.

If my partner is hungover, he/she is no good to me.
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Old 04-24-2008, 11:06 AM   #6
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I remember a lot of students who would take home expired saline and some other supplies to practice, and while it is officially discouraged on one hand it is also admirable on the other.

Who bothers with IV anyway? Why waste the time just to look cool? Drink a glass of water instead, for all the good it will do you.

Want to beat a hangover? IV and O2 isn't the best solution. Prepare the night before: before calling it a night, have 2 tylenol and a multivitamin beside your bed and a high-carb meal, like a meatball sub in the fridge. Consume when you get home with several glasses of water or milk (think about alcoholic ketoacidosis!). Then crash.

Wake up about 2 hours before you need to, urinate and then consume a gatorade and go back to bed. Wake up and shower in cool water.

Your as good to go as any other morning.

Oh, and one last point, and it is very important: for every drink that you have, you will require 1 hour of sleep to match it. Otherwise if you go to bed at 5 AM with a bloodstream full of fresh alcohol, no hangover cure will help you at 7:30.

Unless you try Narcan, but as I've never given it to a drunk and never disliked my career enough to be so wreckless as to be a guinea pig so I can't speak to its effectiveness. I've heard debates both ways though. Alcohol is a class IV narcotic and there are clinics that tout its usage for treating alcoholics with DT, but I just don't know because this is one where the proof is in the putting.
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Old 04-24-2008, 11:56 AM   #7
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So does the Saline aid in ridding of the hangover? How would that work? (an honest question)

And for the drunk pt, would the saline help 'prevent' a hangover, or more for fluid 'replacement?' (I'm not sure on the correct term...)

Thanks ! (interesting topic, I've always wondered myself)
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Old 04-24-2008, 12:27 PM   #8
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i know someone who was just let go because he did this exact thing, im not sure on details, so i dont know if it was at work or at home
yes, I know who you are talking about, it is against the rules at pretty much all the squads in our EMS council
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Old 04-24-2008, 02:47 PM   #9
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a big part of a hangover is electrolyte imbalance and dehydration. while a liter of isotonic saline will aid in teh correction of the dehydration(although as previously mentioned, not significantly better that po fluids), its really more of a placebo/cool guy routine.
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Old 04-24-2008, 03:35 PM   #10
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yeah, it is really no advantage to a conscious person over a couple of salty crackers and a few cups of water or a large gatorade. But if you were to place a saline lock before going out and tipping at windmills and then starting a bag before going to bed, then there would be more noticable benefits. Personally, I would rather set my alarms to go off every other hour, roll over to turn them off and drink a glass of water at the same time.

There's quite a lot that happens during alcoholic consumption that leaves the body feeling gawd-awful the next day. Dehydration, electrolyte imbalance, hypoglycemia, excess calcium channeling, decreased bioenergetics d/t ineffective Krebbs cycles, etc.

An IV won't fix that alone as you can guess. Water, gatorade, high-carb meal, multivitamin, tylenol and plenty of sleep would be the prescribed fix.
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