How (not) to Cannulate in the Antecubital Fossa (ACF)

Working on a pre hospital emergency you can be forgiven certain etiquettes in standard procedures.  Like intubating a patient whilst they’re on a filthy floor in a corner of a darkened room. But, as long as there is no ‘real’ harm done to the patient then it should be fine . . . shouldn’t it?

I opened the roller clamp on the IV Paracetamol and held the bottle above the patient’s head to watch the flow.  But, instead of seeing the drips coming down, I saw the patient’s blood run vertically up the tube toward the bottle!

Ah . . . I thought, this is awkward . . .

Try and aim for the blue bits

Antecubital Fossa (ACF)

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Pain In The Heart

I was being ushered into the house by the patient’s immediate family.  Their looks of grave concern was matched by their eagerness to get me to the patient as quickly as possible.  This sort of behaviour generally makes up your global overview of what is going on and how serious the situation potentially could be.

I therefore decided not to make ice breaking jokes at this particular time and instead, took it as serious as the atmosphere dictated.

Inside were more family members, some of the older women crying.  They all ushered me upstairs to where the patient lay on a bed, one hand clutched to his chest, the other wiping tears from his face.

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