For Veterinary Use Only

As part of our military medical curriculum, we have periodic exercises in combat medical skills.  For example, our last lesson was how to treat exsanguinating hemorrhage using combat gauze and/or tourniquets. Today we learned how to place intravenous (IV) lines by practicing on our classmates.  We set up in small groups with all the necessary equipment.  A few people noticed that our IV tubing said "for veterinary use only" on the packaging.  We laughed about it and figured it must be okay.  After all, med student = guinea pig = animal = veterinary ...good to go.  My partner stuck me first, and after not going in deep enough on one arm, she was successful on the other.  As we were preparing to set up her IV an announcement came on, "if you are using the green tubes please stop immediately and use the blue ones that we are bringing around."  Hmm... "Is that because it says for veterinary use only??" I wondered out loud.  Our preceptor joked back that they had to use up the pig lab supplies somehow.  Side note -- this is the first year that USUHS students have not been able to do cardiovascular labs on pigs, due to political reasons.  Our professors are unanimously disappointed that we are not getting this learning experience, but I digress.

With an experienced student supervising, I began my partner's IV.  I got a flash, but then felt resistance as I tried to advance the catheter, likely meaning that I had gone through the other side of the vein.  Unfortunately my partner will likely have a bruise from that!  She graciously allowed me to try again on her other arm, and with preceptor guidance I successfully placed the IV.  This time I did not sufficiently occlude the vein as I pulled out the needle, and thus there was a stream of blood as I tried to screw on the IV tubing.  It was a successful placement in the end, but my partner started to look pale and put her feet up on a chair.  She knew that she was having a vaso-vagal response (the common "faint") and attempted to increase her venous return by elevating her feet in order to prevent loss of consciousness.  As the preceptor stood behind her holding her up, he said to me, "look at her forehead, what's happening?"  "She's sweating," I said.  "Yes, why?"  "Umm..."  (I was more concerned with the blood all over her arm and my gloves.)  "She's had a vaso-vagal episode, increased vagal tone has caused systemic vasodilation and a decrease in heart rate, which caused her blood pressure to drop, causing a decrease in perfusion of her brain, there is now a sympathetic response activating the muscarinic receptors to cause sweating."  Always a teaching moment in med school:)

At the end of the lab an announcement was made, "So, for those of you who were wondering, the IV tubing was switched out because it was for veterinary use... We checked with occupational health, and it should be okay, but if it touched your skin there may be some allergens or something..."  No worries, I just had fluid running through it INTO MY BODY!!  Anyways, I'm still alive.  For now...