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little_detailsI'm hoping these are straightforward questions, but I couldn't find a way to word the first to get any relevant results in web searches, and the second got weird on me.
The context is a civilian with extensive field-medic-style training providing off-the-books, in-home medical/supportive care to a preteen who is ill with a viral* fever-inducing illness. (* Viral seems easier; but bacterial is possible if necessary.) The setting is the modern-day (or at least vaguely post-2010) United States.
1. Is it feasible to administer intravenous (IV) saline without an infusion pump? (I've been assuming it is but want to double-check.)
As a comparison, I've administered subcutaneous saline to cats. The saline bag has a connected tube; a clean needle is attached to the other end; and the needle is then inserted below the skin in the vet-designated manner. The bag is placed higher than the needle and gravity does the work; a crimping wheel along the tubing controls the flow rate in at least a crude fashion.
I'm writing a sequence that involves IV hydration, and while I've used the same approach as that subQ one, I want to make sure I'm not entirely off-base.
I currently have the patient able to swallow liquid over-the-counter (OTC) medications with coaxing but, at this point, unable/unwilling to eat or drink much else. (No vomiting or outright nausea, just a fever high enough that the poor kid is very sleepy and out of it, with no appetite.) The pseudo-medic determines the patient to be at least slightly under-hydrated and is about to be unavailable for 8-10 hours, so he'd prefer a minor intervention now to a potentially greater one later. The only other character available is a tween who can (try to) continue the oral medications but otherwise has no medical training or skills.
As far as I can tell from web searching, modern IV fever treatment is acetaminophen/paracetamol over 15 minutes, which I've assumed should be done by a pump for safety. Involving a pump affects how later actions are described, though, and switching medications to IV administration would change several scenes For Reasons, so I wanted to check if what I have is at least plausible.
2. Is there a point at which a childhood (viral) fever is dangerous?
I had thought there was a point at which a fever could be brain-damaging or even life-threatening, but when I checked web searches, I just kept finding various clinics (?) saying that wasn't broadly true. What I don't know is whether my initial thought has always been a myth, is a current point of reasonable disagreement, or was once considered medically accurate but no longer is ... and I don't know how to sort that out with the modern web and modern (anti-)medical sentiment being what they are.
UC Davis, for example, tells me that brain damage isn't a risk until 108F and that "It's very rare for the body temperature to climb that high from illness alone." They say to "check with a pediatrician" for certain factors, some of which apply to my character, but that's ... not too helpful.
(I am very deliberately not citing specific temperatures in this story.)
I currently have a character asserting that high fevers are dangerous; he's the pseudo-medic from the IV question above. He is an older man with (long-past) military experience, and his recent medic-like experience is more or less along the lines of a field hospital or clinic -- treating ("simple") gunshots, giving stitches, running medical equipment, etc.
He is able to seek advice from a qualified physician some hours after he makes the assertion, but if so, it happens off-page.
It is very much workable for him to be wrong, but it would help me to know if he's right (I leave his assertion as is) or wrong (I later have another character claim the assertion is no longer considered accurate, or was never true, or is a matter of debate, etc.).
Many thanks!
The context is a civilian with extensive field-medic-style training providing off-the-books, in-home medical/supportive care to a preteen who is ill with a viral* fever-inducing illness. (* Viral seems easier; but bacterial is possible if necessary.) The setting is the modern-day (or at least vaguely post-2010) United States.
1. Is it feasible to administer intravenous (IV) saline without an infusion pump? (I've been assuming it is but want to double-check.)
As a comparison, I've administered subcutaneous saline to cats. The saline bag has a connected tube; a clean needle is attached to the other end; and the needle is then inserted below the skin in the vet-designated manner. The bag is placed higher than the needle and gravity does the work; a crimping wheel along the tubing controls the flow rate in at least a crude fashion.
I'm writing a sequence that involves IV hydration, and while I've used the same approach as that subQ one, I want to make sure I'm not entirely off-base.
I currently have the patient able to swallow liquid over-the-counter (OTC) medications with coaxing but, at this point, unable/unwilling to eat or drink much else. (No vomiting or outright nausea, just a fever high enough that the poor kid is very sleepy and out of it, with no appetite.) The pseudo-medic determines the patient to be at least slightly under-hydrated and is about to be unavailable for 8-10 hours, so he'd prefer a minor intervention now to a potentially greater one later. The only other character available is a tween who can (try to) continue the oral medications but otherwise has no medical training or skills.
As far as I can tell from web searching, modern IV fever treatment is acetaminophen/paracetamol over 15 minutes, which I've assumed should be done by a pump for safety. Involving a pump affects how later actions are described, though, and switching medications to IV administration would change several scenes For Reasons, so I wanted to check if what I have is at least plausible.
2. Is there a point at which a childhood (viral) fever is dangerous?
I had thought there was a point at which a fever could be brain-damaging or even life-threatening, but when I checked web searches, I just kept finding various clinics (?) saying that wasn't broadly true. What I don't know is whether my initial thought has always been a myth, is a current point of reasonable disagreement, or was once considered medically accurate but no longer is ... and I don't know how to sort that out with the modern web and modern (anti-)medical sentiment being what they are.
UC Davis, for example, tells me that brain damage isn't a risk until 108F and that "It's very rare for the body temperature to climb that high from illness alone." They say to "check with a pediatrician" for certain factors, some of which apply to my character, but that's ... not too helpful.
(I am very deliberately not citing specific temperatures in this story.)
I currently have a character asserting that high fevers are dangerous; he's the pseudo-medic from the IV question above. He is an older man with (long-past) military experience, and his recent medic-like experience is more or less along the lines of a field hospital or clinic -- treating ("simple") gunshots, giving stitches, running medical equipment, etc.
He is able to seek advice from a qualified physician some hours after he makes the assertion, but if so, it happens off-page.
It is very much workable for him to be wrong, but it would help me to know if he's right (I leave his assertion as is) or wrong (I later have another character claim the assertion is no longer considered accurate, or was never true, or is a matter of debate, etc.).
Many thanks!
(no subject)
Date: 2025-12-28 02:28 am (UTC)The tricks would be getting multiple vein sites over time if that were needed, and removing the needle and tube in a sterile manner - that setup wasn't designed for much movement. (I could read a book, the needle was taped down, but I don't think it'd have lasted overnight or for extended sleeping well.)
(no subject)
Date: 2025-12-28 02:56 am (UTC)You count the drips from the bag into the little chamber on the fluid line. The lines I'm familiar with either run 10 drips/mL or 15 drips/mL. It takes a little math but you can figure out how many drips per minute or second you need to reach whatever fluid rate or amount you're going for. It is not something you can just 'set and forget', sometimes movement of the IV catheter/needle site, or bending the limb with the IV in it, can alter how easily the fluids run so you may need to adjust how open the line is now and then.
2. Medical paper on fevers, yes high enough fevers will damage cells.