Injections and I.V.s in the Future

Well, I think our future robot overlords will just unscrew a cap and top off when they need more fluid. Oh, you meant for the meat bags that are left.

IV's are pretty efficient. The only thing that comes to my mind that would be more efficient would be nano-bots that could create saline, vaccines, and artificial what-evers on demand while inside the human body. Perhaps pulling the atoms and chemicals to create protein chains directly from human waste. Imagine never having to be dehydrated because the nano-bots are pulling 2 hydrogen and 1 oxygen atom that would have been excreted because they were bound to something else in your waste and turning it into a water molecule and releasing it back into the body where its used again.

Creepy as hell to think about but far more efficient than IV's. Plus it's pure fiction.

I'll second nanotech as a possibility, though not in the immediate future. Also distant is transportation technology. Scientists can transport single, very small particles (I think on the order of atoms, maybe not even that large yet). Eventually, molecules and fluids will be transportable. It would function like a Star Trek hypospray appears to work, but with actual transportation technology instead of the "compressed air" garbage.

Other possibilities mostly focus on the medication inserted, absorption rates, anti-viral medicines, etc, and not the delivery method itself. I agree with your RN friend, the needle is pretty dang efficient and not likely to change in our lifetimes. Beyond that, it gets really hard to guess what will come out of the R&D labs.

For injections we already have versions with no needle where high pressure causes a fluid jet to pierce the skin. This has huge advantages in avoiding cross transmission, accidental sticks and wastage.

veinglory said:

For injections we already have versions with no needle where high pressure causes a fluid jet to pierce the skin. This has huge advantages in avoiding cross transmission, accidental sticks and wastage.

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For IV's, probably not. There isn't a good way to tell a high pressure fluid stream when to stop injecting. A constant stream would go all the way through in rather short order.

Manufacturing uses very-high-pressure water streams to cut metal now.

Well there is no need to change the current technology besides pain and bruising.

Pain and bruising will be improved in the future by using finer needles through nanotechnology. Needles so small that they won't be felt or cause damage to surrounding tissue at the site.

Besides that they are also trying to use nanoparticles to deliver drugs specifically to the location they are intended. This will be instead of just flushing the blood with a drug in a concentration that is high enough to both help the body and cause side effects. These nanoparticles are also being tested to be rubbed on the skin so that they can have a more faster, focused and local affect on the area of the body that requires the drug.

One thing that's sticking in my mind here is my last flu shot. Keep in mind, I've spent probably seen a fair number of needles in my life, but the nurse I had received my shot from managed it without any pain and no outward bruising. Of course, it was a little sore later, but it was probably in the top ten of needle sticks I've had in my life.

Just focusing on injections here for a moment.

I did a little fact checking on jet injectors, a.k.a. hyposprays*. There's one kind that has found use in the military which is cleaner and more efficient, at the cost of being more painful (counterintuitive, right?) and leaving a bleeding puncture wound. There's another type that MIT has developed which resolves those drawbacks while also delivering another trick, in that it can also deliver variable doses (in terms of both volume and speed) and, more importantly, deliver powdered medications which can last much longer in the field without refrigeration.

Unfortunately, the reality of jet injectors is a matter of economy and capitalism. It's the same problem society has right now with pursuing alternative energy. There's entire industries that have grown up around the existing technologies who are very keen to—shall we say—financially motivate politicians in order to avoid becoming obsolete. There's nothing preventing a pharmaceutical from charging the same price for a batch of prepared syringes as a bulk supply of powder, and thus make it more financially viable for large hospitals to favor the former, especially when the syringes work just as well on IV's.

The question of if science can ever create something as efficient, well, it really depends on how you want to define that term.

*Incidentally, Star Trek's iconic Hypospray came into being because NBC's Standards & Practices forbade the portrayal of using hypodermic needles. Just an interesting factoid I came across.

Drawing on my knowledge of physiology (it's what I studied in grad school), I'd think that needles will remain the best way to get large volumes of fluid into patients relatively quickly. All the other ideas mentioned might work for smaller quantities (the nanobots wouldn't be able to make something from nothing, and if a person is a quart of plasma down, I can't see how they could spontaneously produce enough water from waste products, and the needed salts/minerals would have to be present in the body already in some form. Plus, the energy they'd need to do this would have to come from somewhere).

The only possible way around the limitation with fluids might be something that temporarily makes your skin very absorbent, so fluids could be taken up very quickly via that route (via osmosis, like we were frogs). But they'd have to be slightly hpoosmotic (more watery) than your bodily fluids for this to work, so it would be easy to overdilute your patient.

No technology will ever get us past the "you can't get something for nothing" principle (aka the First Law of Thermodynamics).

This doesn't mean that there won't be more efficient methods of getting medications onto the body in the future. We're already starting to have those. There are even transdermal patches for some drugs (lipid soluble compounds work best here). And nanotechnology might be wonderful for delivering small quantities of medication to specific tissues (and if you can target the specific tissue or cells that needs the medication, you could give much lower dosages too).

The answer may not be whether there is a better way but whether medical device makers can make more money with something else. I am not all that familiar with what is in use now, but I would think that some sort of computer controlled pump on IV's in addition to nanos doing something would give the manufacturers more profit.

A nano guided flexible needle that would always put the end of the needle at the best place with the least pain and incidental damage. That would increase profits, and it would sound to patients that they were getting something better.

We're doing a lot with arthroscopic surgery recently. I wonder if targeted medicine delivery might not be a future procedure for an arthroscope?

robjvargas said:

We're doing a lot with arthroscopic surgery recently. I wonder if targeted medicine delivery might not be a future procedure for an arthroscope?

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Most definitely. Just like the rubs RDArmstrong mentioned, localized injections are much preferred. It is already the standard in dental procedures and others, where local anesthesia is commonly used. As our ability to place needles in specific places increases, and as those needles get smaller and harder to break, you can bet arthroscopic methods (and others) will be used to administer medications to specific organs and other areas, like cancer tumors deep in the body.

Locke, there is definitely momentum built up behind needles and such. But just like alternative energy, that momentum will break down in the long run. It just takes years (or decades) longer than it has to.

In the 1960s some work was done with dimethyl sulfoxide, or DMSO. At the time, its main market was as a horse liniment. Someone discovered that DMSO would penetrate skin rapidly and carry along anything that was mixed with it.

There was some work done with drug delivery via DMSO patches in the 1960s. I don't know if modern drug patches use DMSO or a different carrier.

The CIA and KGB allegedly used DMSO to make contact poisons.

I'd agree that for getting large quantities of fluid into a person, you pretty much need to just pour it into them, and a needle is the best way.

I can see getting medicine or vaccines into a person eventually relying on different technology, however. If you can get the stuff into the person without a risk of infection (either to the patient or to those who handle the equipment later), then that would be valuable. You could eliminate a big percentage of needle-stick injuries to health care workers if you could drastically cut down how often a needle is required at all.

Also, squeamish babies such as myself would be much happier with a hypospray, if it wasn't painful. I have a lot of trouble dealing with the sight of a piece of metal in my arm.

Is Hypospray specific to Star Trek? I tried googling it but I'm only coming up ST...

With my Sci-fi YA, I have characters who inject themselves all the time with a solution they need to survive... and I never once second guessed it until now, wondering if a Jet Injector would be better. But is HypoSpray a ST copyrighted name?

Also, what would be the bridge between the two for those that sit in suspension tanks to sleep and needles would be the norm? Pads on the limbs? Doesn't make sense to have needles one moment and not the next.

Maybe one thing that will happen is that the need for IVs will reduce a lot as patients rarely need them

Channy said:

Is Hypospray specific to Star Trek? I tried googling it but I'm only coming up ST...

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See my little postscript in post 7 about how the hypospray came to exist in Star Trek and thus exposed it as a sci-fi staple. It's actually sort of an interesting comment on the standards and practices of its day.

But your question regarding trademarks (you can't copyright a term, I don't believe) is somewhat interesting because it reveals that the concept of the jet injector was conceived well before Star Trek. It was originally registered in 1947 by the R.P. Sherer corporation, and again in 2013 by Transdermal Delivery Solutions Corp. Keep in mind, that only means that they're the only ones who can market a thing called a "Hypospray." That doesn't preclude a work of fiction (or non-fiction, for that matter) from portraying the use of a hypospray, or from drinking from a thermos, or eating an oreo, or listening to They Might Be Giants.

Heck, if we're in science fiction mode let's equip ourselves with a USB port.

Shortly after birth, humans go into the medical equivalent of a garage and have themselves upgraded. What shall we say?

A medical USB port to take care of any injections we might need in our lifetimes?

A cranial implant to do all the thinky stuff and wire us into the internet?

We could even go the whole hog and have our kidneys replaced with far more effective mechanical units which could even include nano-level 3d printers. Who needs IV and hypodermic needles then? If our body needs a drug we can just make it ourselves and administer it internally.

And if we are living in Iain M. Banks culture we could gland some snap and have a party.

Once! said:

We could even go the whole hog and have our kidneys replaced with far more effective mechanical units which could even include nano-level 3d printers. Who needs IV and hypodermic needles then? If our body needs a drug we can just make it ourselves and administer it internally.

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*traps plot bunny and runs*

Once! said:

Heck, if we're in science fiction mode let's equip ourselves with a USB port.

Shortly after birth, humans go into the medical equivalent of a garage and have themselves upgraded. What shall we say?

A medical USB port to take care of any injections we might need in our lifetimes?

A cranial implant to do all the thinky stuff and wire us into the internet?

We could even go the whole hog and have our kidneys replaced with far more effective mechanical units which could even include nano-level 3d printers. Who needs IV and hypodermic needles then? If our body needs a drug we can just make it ourselves and administer it internally.

And if we are living in Iain M. Banks culture we could gland some snap and have a party.

Click to expand...

There are people who have implanted ports for their insulin pumps, but there's a risk of serious infections anytime you put a permanent breach into the wonderful keep-stuff-outer that is our skin. I think something like a USB port for medicine could become a real thing someday; we just need to get better at it.

As for cranial implants, let me recommend a great set of books (although the first one is weaker than later ones in the series): In Richard K. Morgan's Takeshi Kovacs novels, people are fitted with a "stack" in the back of their necks at birth. This records their life so that when they die, they can be uploaded into another "sleeve" (biological body.)

Everyone's pretty much immortal as long as they can afford a new body, and the books deal extremely well with the social implications of that fact. E.g. people feeling obligated to save up for their parents' re-sleeves; there is a tendency for people to leave their spouses at "death" so they can enjoy their nubile new body; if someone commits a crime, they're put into "storage", resulting in the criminal becoming displaced in time relative to their spouse as well as getting the body of a stranger once they come out of storage (which is pretty hard on the spouse, too.)

Surely there would be a timeline which would allow for all this tech?

In the next twenty years or so, we focus on making better needles. Yuck. I hate needles.

Around 2040 or thereabouts, most humans are fitted with a medi USB port. Having solved the infection and rejection problem. Somehow. Insert hand-wavy tech here. Literally.

Medi USB ports become obsolete in 2070 when artificial kidneys can make any drug that the human body needs and administer it from the inside.

By this time we don't need doctors. The cranial chips implanted in our brains contain enough medical knowledge to diagnose and treat all diseases.

By 2100, medicines become obsolete for the richest in society as they gain access to mechanical bodies. We become as good as immortal.

Unfortunately, by this time the human population of the earth has reached 20 billion and there isn't enough room for all of us. And even more unfortunately, it turns out that Einstein was right. No faster than light travel for us, I'm afraid.

But that's okay. The same technology that can hook us into an artificial body can also hook us into virtual reality at such high resolutions that we can't tell it from reality.

Be careful what you wish for.

I'd just like to point out that disease isn't going anywhere. Every time we solve a disease, others replace it. Why? Because we don't solve diseases in a vacuum. As our lifespans increase, problems we never considered become common. Things like cancer and alzheimer's and failing hearts and strokes. As we "cure" these issues, our lifespans will increase and we will have new problems (or perhaps worse variations of existing problems).

Humans also have the nifty ability of killing ourselves slowly. Even if it isn't drugs like alcohol (or worse) destroying our bodies one dose at a time, when faced with prosperity we eat way too much or eat things that aren't good for us. Diabetes, kidney failure, the list goes on. If we somehow make kidneys capable of regenerating, wouldn't people just drink more? What about other effects of alcohol use, particularly stretched out over a longer lifespan?

If that wasn't enough, humans have also proven very good at killing each other. Biological weapons and the like are only going to get easier to produce as technology becomes more widely available and the knowledge required becomes more distributed. When we start seeing massive outbreaks of man-made diseases that resist treatment, that will add all kinds of new issues.

Some day, we will hopefully explore the stars. Mathematically speaking, we will run into other planets with life on them. Even if it isn't sentient, it will probably cause disease of one form or another in us. And if humans should settle on a world with a different mix of pretty much anything (oxygen, helium, heavy metals, etc), it will cause health problems we haven't seen before. Additionally, until we can come up with better shielding for spacecraft, explorers running around out there are going to be exposed to charged particles and photons from cosmic rays, solar flares, and all kinds of other things. That extra radiation will be a problem for the medical community.

Say we solve those problems. What about extended exposure caused by one spaceship firing on another, disrupting their anti-radiation shielding? What about psychological disorders developed when people start living to 150 or 200 or 250 years old?

If we manage to implant our minds into machine bodies, we just trade one set of problems for another. Psychological disorders will multiply as people live longer and longer. Memory storage and access times, along with memory degradation, will become an issue. Piracy of memories will be a thing, as will hacking people or entire nations and controlling people's bodies remotely. As a mechanical body can't feel, we would need some method of stimulating sensation; as soon as that exists, people will find ways to abuse it with "mechanical drugs" or whatever. Freed from our bodies, how will we reproduce? Clones, synthesized eggs and sperm? Only lower class "real humans" reproducing while upper class society stagnates with the same people in power for centuries?

If we learn to implant our minds into another human body, we still have to deal with psychological issues. And the ethical problems of taking a body from someone else, or else the means to grow a ready-made replacement somehow. And if widespread and no one ever truly dies, that will create a huge strain on our resources and directly lead to war over those resources. Additionally, the human brain only has so much storage space available, so we'd need to compensate with mechanical devices or genetically-altered brains, either of which will lead to new problems. Or perhaps some means of selecting which memories to take with us to the new body, which could lead to interesting psychological issues.

Naw. Disease isn't going anywhere. It will just change shapes.