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View Full Version : Can you take someone's blood while in a moving ambulance?



Project nachonaco
09-03-2009, 12:29 AM
Can you take a blood sample while riding in an ambulance, or is finding a vein site too dangerous?

The person in question is being tied down so they CAN get her blood.

Kitty Pryde
09-03-2009, 12:43 AM
When I have seen paramedics turn up at a scene, they usually put in an IV line before they leave, so they don't have to 'find a vein' while driving. If it's a super-duper-mega emergency, they just throw you in the ambulance and go, tho.

BUT. I'm pretty sure they don't take blood in the ambulance, they take blood in the hospital to do tests. Why are your paramedics taking blood in the ambulance?

AND. Ambulance or not, even if someone is in restraints, in my experience you have to knock em out or have two or more people hold them down to put in an IV line.

Wiskel
09-03-2009, 01:43 AM
You could try, it's not impossible, but there's very little point.

It would be tricky and you'd have a very hard time getting the needle into the vein. If you make a mess of the arm then you make the job harder to do at the hospital. If you actually harm the person then you may get sued.

If you're not careful enough getting the blood then you can haemolyse the sample (actually damage the cells within it) and then the lab isn't going to be able to give you all of the results you wanted as haemolysis messes a few of them up.....if you did this you'd delay getting your results, not speed them up.

There's nothing you can do with the blood in the ambulance apart from admire your handiwork.

There is no condition that is so urgent that the extra two minutes it would take to get the blood on arrival at the hospital means the difference between life and death.

Still, I'll lay good money that it has been done before and will be done again.

Craig

Project nachonaco
09-03-2009, 01:50 AM
She isn't going to a hospital, more like a military compound. I just thought it'd be neat to dosomething different.

jclarkdawe
09-03-2009, 02:13 AM
You don't get blood samples in a rig. Absolutely no sense in it. And even if you did, the vibration would probably kill it as a usable sample.

You can, with someone with really good veins, on a super good road, start an IV. Patient needs to have a minimal pain response. But usually it's easier to pull over to the side of the road. As stated, if those two minutes are really going to make a difference, I'd be surprised. It's very rare that you can't maintain a patient in an ambulance, and if they're crashing that fast, an extra minute or two isn't going to save them.

If you want a great procedure for the back of a rig, go with a nasal airway, or a nose hose. It's used in a conscious patient to get a better airway. It's a rubber tube that's inserted into one nostril. Usually it is lubricated, but with a nasty patient, you can really get their attention by not lubricating it. It can be done by any EMT and road condition doesn't matter. You can see more about it at Nasopharyngeal airway - Wikipedia, the free encyclopedia (http://en.wikipedia.org/wiki/Nasopharyngeal_airway)

Best of luck,

Jim Clark-Dawe

Tsu Dho Nimh
09-03-2009, 09:41 PM
The question I have - and I've taken lots of blood samples under adverse conditions as a med tech - is WHY they need to take the sample.

Nothing medically useful can be done to a venous blood sample by an EMT or paramedic. If they need glucose levels they stab a finger. If they need O2 levels, they use that thumb thingy (pulse oximeter?) For anything else, you need lab equipment like centrifuges, cell counters, chemical analysis equipment.

To my knowledge (I've only rummaged through the supplies in a few ambulances) they don't even carry any of the specialized blood collection tubes used for collecting medical samples. Gloves - they got lots of gloves.

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Adding - given a quiet (calm or comatose) patient with good veins on a good road ... it would be no harder than taking blood from a fighting drunk who has three cops and a janitor piled on top of him, or a toddler who knows what's coming.

ColoradoGuy
09-04-2009, 02:00 AM
Yes. I've done it in a helicopter getting tossed about in the wind. An adult with veins easily felt in the arm after putting on a rubber tourniquet is not all that difficult.

GeorgeK
09-05-2009, 05:21 AM
I've taken blood from a psych patient who was so combative there were orderlies and nurses and probably the receptionist, one or two to a limb and then another guy sitting on top of a mattress over the patient with the patient pinned to the bed with only his face and arms sticking out, like some bizarre Itchy and Scratchy human sandwich. People forget about how easy it is for a patient to twist their arm even if you have a whole crew to attempt to restrain them. So, yes it could be done in an ambulace, but as everyone has said, "Why would you want to?" For a fiction plot twist I can think of several, but not for medical reasons.