We usually administer intravenous fluids to a patient for 24 hours after a cesarean section. Since cesarean sections are performed at all times, there are patients who have received intravenous fluids for 0 to 24 hours in the postoperative ward at any given time. We often find that a patient is without any fluid going into her vein even if it has been a short time after the cesarean section. The nurses offer different reasons for the same, some of which are as follows, and all of which I trust are true.
Despite clear instructions, the Resident Doctors are unable to enforce continued administration of IV fluids, because the disconnection usually happens when they have gone away from the ward. That day I found a patient with an intravenous cannula in place, but no fluid bottle connected to it through an infusion set. There were three infusion bottles hung on an IV stand as shown in my 3D model below. It had been just 11 hours since the patient had undergone a cesarean section.
"Where is her IV infusion?" I asked. The Registrar put on a confused expression and said nothing.
"Are all of these bottles for this patient?" I asked. Someone called the nurse, who declared,
"Yes. We have her remaining fluid bottles ready on the stand. We will give them to her one after another."
"Keeping all bottles opened will result in contamination of their external surface, and those bacteria will enter the bottles when the bottles are pierced with the end of the infusion set" I said.
"Um..." the nurse said. I took it to mean she had understood it and would not do so again.
"There is no infusion tube between any of the bottles and the intravenous cannula" I pointed out. "Is the connection WiFi?"
The Associate Professor laughed. I think the others either did not get the joke or were to scared to laugh.
- I was going to start the next bottle of fluid just now.
- I disconnected the fluid infusion because the servant was changing the patient's dirty gown.
- I have just come on the duty, and learned that IV fluid is to be given to this patient. I will do it right away.
- The nurse who has to do it has gone somewhere on duty. I will do it right away.
Despite clear instructions, the Resident Doctors are unable to enforce continued administration of IV fluids, because the disconnection usually happens when they have gone away from the ward. That day I found a patient with an intravenous cannula in place, but no fluid bottle connected to it through an infusion set. There were three infusion bottles hung on an IV stand as shown in my 3D model below. It had been just 11 hours since the patient had undergone a cesarean section.
"Where is her IV infusion?" I asked. The Registrar put on a confused expression and said nothing.
"Are all of these bottles for this patient?" I asked. Someone called the nurse, who declared,
"Yes. We have her remaining fluid bottles ready on the stand. We will give them to her one after another."
"Keeping all bottles opened will result in contamination of their external surface, and those bacteria will enter the bottles when the bottles are pierced with the end of the infusion set" I said.
"Um..." the nurse said. I took it to mean she had understood it and would not do so again.
"There is no infusion tube between any of the bottles and the intravenous cannula" I pointed out. "Is the connection WiFi?"
The Associate Professor laughed. I think the others either did not get the joke or were to scared to laugh.
