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(EurekAlert)   Ringer's lactate is the superior IV solution, something Dr. Kelly Brackett of Rampart General Hospital has been telling us for nigh on 50 years   (eurekalert.org) divider line
    More: Followup, Lactated Ringer's solution, Intravenous therapy, Saline, Intravenous fluids, saline solution, hospital patients, Blood, new study  
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812 clicks; posted to STEM » on 30 Jun 2022 at 8:38 AM (5 weeks ago)   |   Favorite    |   share:  Share on Twitter share via Email Share on Facebook



34 Comments     (+0 »)
View Voting Results: Smartest and Funniest
 
2022-06-30 9:01:45 AM  
 "For our health system alone, that's 3,000 people every year who may avoid complications from normal saline, at no additional cost."

"Lol" -- Every for-profit hospital system
 
2022-06-30 9:14:41 AM  
It's got electrolytes!
Documentary suggests trying Brawndo.
 
2022-06-30 9:24:33 AM  
But what about D5W?
 
2022-06-30 9:30:57 AM  
 
2022-06-30 9:42:11 AM  
Dammit, it is time that the good doctor get an EMERGENCY retirement.
 
2022-06-30 9:43:54 AM  
So the theory is it's about pH differences.  OK.  My immediate first question is... is there a safe way to adjust the pH of saline solution for injection into a human?
 
2022-06-30 9:55:16 AM  
Just looked it up. He's still alive. The other doctor and the nurse have been dead for over two decades.
 
2022-06-30 9:56:37 AM  
They had PHONES in their trucks!
pbs.twimg.comView Full Size
 
2022-06-30 10:01:36 AM  

Unsung_Hero: So the theory is it's about pH differences.  OK.  My immediate first question is... is there a safe way to adjust the pH of saline solution for injection into a human?


pH is easy to control. That's why these are called buffers, Phosphate works great. The body does it with carbonate, but unless it is constantly maintained that isn't stable.
 
2022-06-30 10:23:25 AM  

IgG4: They had PHONES in their trucks!
[pbs.twimg.com image 552x357]


Man, I loved that show as a kid. Never seen it since (even if it's on a few day a week) and not going to. Learned that lesson.
 
2022-06-30 10:29:33 AM  

Unsung_Hero: So the theory is it's about pH differences.  OK.  My immediate first question is... is there a safe way to adjust the pH of saline solution for injection into a human?


It's less about the pH of the solution. The lactate within the solution is itself the raw material for the modulation of serum pH via the natural bicarbonate buffering system used in the blood. This allows greater engagement by both the kidneys and lungs in regulating serum pH.

I don't think they should sleep on the value of the potassium and calcium in there for less stress on the kidneys. It always struck me as strange that you would replace volume with normal saline, an effectively slightly hypernatremic solution...
 
2022-06-30 10:34:51 AM  
Send them a strip!
 
2022-06-30 10:36:31 AM  
How'd I miss this:

Fark user image
 
2022-06-30 10:46:11 AM  

IgG4: They had PHONES in their trucks!
[pbs.twimg.com image 552x357]


And weren't universally white supremacists.
 
2022-06-30 10:47:04 AM  

FlashHarry: How'd I miss this:

[Fark user image image 612x58]


Something, something, helmet joke.
 
2022-06-30 10:56:35 AM  
Station 51 KMG365
 
2022-06-30 11:06:18 AM  

drewogatory: IgG4: They had PHONES in their trucks!
[pbs.twimg.com image 552x357]

Man, I loved that show as a kid. Never seen it since (even if it's on a few day a week) and not going to. Learned that lesson.


It actually holds up reasonably well, much less overtly racist and misogynist than a lot of the related shows.
 
2022-06-30 11:24:19 AM  
Lactated Ringer solution contains electrolytes

I should try that on my plants.
 
2022-06-30 12:11:19 PM  
Interesting...

This study was from here in SLC, and even though it's a different hospital company (Is that what they're called?), when my wife ended up in the hospital 2 weeks ago for gallbladder issues, they gave her lactated ringers, which was the first time I'd ever heard someone use those not on a TV show or movie. When I went to the ICU 2 years ago in sepsis and severely dehydrated, it was just saline they gave me then.

And then when I asked what a lactated ringer was, exactly, and why they would use one over the other, they cited the line in this study almost word for word...
 
2022-06-30 12:44:37 PM  
Drax lacs
 
2022-06-30 12:45:28 PM  
Back in the 90s when I was on the floor of the Navy hospital, everyone used LR. But then for the Department of Defense, budget was NOT an issue.
 
2022-06-30 1:16:42 PM  

drewogatory: IgG4: They had PHONES in their trucks!
[pbs.twimg.com image 552x357]

Man, I loved that show as a kid. Never seen it since (even if it's on a few day a week) and not going to. Learned that lesson.


it - well, it, yeahhh, don't.

but that fire station alert  -BOOOO BOOOP ANNNNNKH
holy cow was that audio crack to my 8 year old ears
 
2022-06-30 2:07:56 PM  

I am Tom Joad's Complete Lack of Surprise: IgG4: They had PHONES in their trucks!
[pbs.twimg.com image 552x357]

And weren't universally white supremacists.


One of the two main leads was not white. That had at least one recurring black doctor. And the dispatcher voice was done by a black guy who did the job in real life. One of the secondary cast members was hispanic. This was pretty good for the time. They did address the issue from time to time.  Still no cure for the really cheesy and often cringe worthy dialogue between the almost universally great rescue sequences.
 
2022-06-30 2:27:36 PM  

elvisaintdead: drewogatory: IgG4: They had PHONES in their trucks!
[pbs.twimg.com image 552x357]

Man, I loved that show as a kid. Never seen it since (even if it's on a few day a week) and not going to. Learned that lesson.

it - well, it, yeahhh, don't.

but that fire station alert  -BOOOO BOOOP ANNNNNKH
holy cow was that audio crack to my 8 year old ears


And the longer it went on the crackier it got.
 
2022-06-30 3:41:57 PM  
Yeah, loved that show as a kid. I even figured out the number of alarms determined the severity of the call. I even had the John and Roy action figures.
 
2022-06-30 3:47:17 PM  

common sense is an oxymoron: elvisaintdead: drewogatory: IgG4: They had PHONES in their trucks!
[pbs.twimg.com image 552x357]

Man, I loved that show as a kid. Never seen it since (even if it's on a few day a week) and not going to. Learned that lesson.

it - well, it, yeahhh, don't.

but that fire station alert  -BOOOO BOOOP ANNNNNKH
holy cow was that audio crack to my 8 year old ears

And the longer it went on the crackier it got.


When my mother was still alive I used that audio as her ringtone on my phone.  She usually only called me if it was an emergency (she hated using the phone) and I wanted something I could hear in any environment.
 
2022-06-30 3:47:59 PM  
I'm a DVM. We were taught to use LRS forty years ago, and every vet clinic I've ever worked at used LRS as our default fluid treatment. Why is it just becoming a thing now in human medicine? Using the fluid closest in composition to the fluid you're replacing seems like a no-brainer.
 
2022-06-30 4:03:27 PM  

TheMysteriousStranger: I am Tom Joad's Complete Lack of Surprise: IgG4: They had PHONES in their trucks!
[pbs.twimg.com image 552x357]

And weren't universally white supremacists.

One of the two main leads was not white. That had at least one recurring black doctor. And the dispatcher voice was done by a black guy who did the job in real life. One of the secondary cast members was hispanic. This was pretty good for the time. They did address the issue from time to time.  Still no cure for the really cheesy and often cringe worthy dialogue between the almost universally great rescue sequences.


Same as Star Trek.

Yet here we are; upfront witnesses to the rise on the American Reich as more than half the population clearly could not care less.
 
2022-06-30 4:06:36 PM  

goddamdoggiedoctor: I'm a DVM. We were taught to use LRS forty years ago, and every vet clinic I've ever worked at used LRS as our default fluid treatment. Why is it just becoming a thing now in human medicine? Using the fluid closest in composition to the fluid you're replacing seems like a no-brainer.


It took them a while to decide on what to charge for it.

Slightly below the price of HP printer ink.
 
2022-06-30 4:19:24 PM  

I am Tom Joad's Complete Lack of Surprise: goddamdoggiedoctor: I'm a DVM. We were taught to use LRS forty years ago, and every vet clinic I've ever worked at used LRS as our default fluid treatment. Why is it just becoming a thing now in human medicine? Using the fluid closest in composition to the fluid you're replacing seems like a no-brainer.

It took them a while to decide on what to charge for it.

Slightly below the price of HP printer ink.


TBF, they wasted a LOT of time trying to find something that would work for both.
 
2022-06-30 4:45:28 PM  

elvisaintdead: drewogatory: IgG4: They had PHONES in their trucks!
[pbs.twimg.com image 552x357]

Man, I loved that show as a kid. Never seen it since (even if it's on a few day a week) and not going to. Learned that lesson.

it - well, it, yeahhh, don't.

but that fire station alert  -BOOOO BOOOP ANNNNNKH
holy cow was that audio crack to my 8 year old ears


Use it for a ring tone.

Remember James Coburn's "Flint" movies?  In Like Flint, Our Man Flint?  That weird phone sound he used?

I set that up as my ring tone on my cell.

Flint presidential telephone ringtone SFX (clean)
Youtube CokN5HgyfD8
 
2022-06-30 9:47:29 PM  

goddamdoggiedoctor: I'm a DVM. We were taught to use LRS forty years ago, and every vet clinic I've ever worked at used LRS as our default fluid treatment. Why is it just becoming a thing now in human medicine? Using the fluid closest in composition to the fluid you're replacing seems like a no-brainer.


Depends one the clinical situation. A lot of times pH is fine and you want better control of other electrolytes without having to calculate what's coming in from the LR. For standard maintenance IVF saline is a fine vanilla choice you can flavor to your heart's content. Surgeons have always tended to like LR, and that's the fluid I'll reach for with our complicated patients with gut bicarb losses so I can stay ahead of acidosis without having to calculate mili-eqs of bicarbonate or move to tham. Makes sense for ICUs too since many of their patients have poor perfusion and at risk for acidosis too.
 
2022-06-30 9:57:59 PM  

Iamos: goddamdoggiedoctor: I'm a DVM. We were taught to use LRS forty years ago, and every vet clinic I've ever worked at used LRS as our default fluid treatment. Why is it just becoming a thing now in human medicine? Using the fluid closest in composition to the fluid you're replacing seems like a no-brainer.

Depends one the clinical situation. A lot of times pH is fine and you want better control of other electrolytes without having to calculate what's coming in from the LR. For standard maintenance IVF saline is a fine vanilla choice you can flavor to your heart's content. Surgeons have always tended to like LR, and that's the fluid I'll reach for with our complicated patients with gut bicarb losses so I can stay ahead of acidosis without having to calculate mili-eqs of bicarbonate or move to tham. Makes sense for ICUs too since many of their patients have poor perfusion and at risk for acidosis too.


That's it. See, only speciality clinics or universities usually can measure acidosis in vet med. if we have something metabolically complex it goes to those places, unless the owner can't afford referral. Then we kinda shoot in the dark and do the best we can.
 
2022-07-01 10:24:25 AM  

Nicholas D. Wolfwood: elvisaintdead: drewogatory: IgG4: They had PHONES in their trucks!
[pbs.twimg.com image 552x357]

Man, I loved that show as a kid. Never seen it since (even if it's on a few day a week) and not going to. Learned that lesson.

it - well, it, yeahhh, don't.

but that fire station alert  -BOOOO BOOOP ANNNNNKH
holy cow was that audio crack to my 8 year old ears

Use it for a ring tone.

Remember James Coburn's "Flint" movies?  In Like Flint, Our Man Flint?  That weird phone sound he used?

I set that up as my ring tone on my cell.

[Youtube-video https://www.youtube.com/embed/CokN5HgyfD8]


heh. I had that one too for years.  *dooodeedlydeedleydeedeedleydooooo*
people would give me the strangest looks unless they knew and then they loved it
 
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