There are things that you will notice when you have had to deal with it. Occupational deformation. If, like me, you sometimes have to inject an IV in a hospital, you run the risk of seeing blood vessels everywhere in the streetscape. Construction workers with whoppers of cables resting on their muscular forearms, a skinny woman behind a walker with skin so loose that the barrels roll in all directions. It continues to fascinate me involuntarily.
I’ve always enjoyed it. There are few things that can make patients happy in the hospital as quickly as with a well-aimed injection. The act seems trivial. It’s the moment when you grab a stool next to the bed, let the tourniquet do its job and in the meantime catch a glimpse of a whole life. When you grab someone’s hand to jab it, the natural reflex is to tense the muscles. A tense hand or arm cannot be pierced. It is therefore important to establish a bond of trust, despite the fact that you are about to hurt someone.
There’s no needle in your arm
The method of administering medicines via the bloodstream or, conversely, removing ‘contaminated’ blood has existed in medicine for several centuries. The principle is simple. An infusion consists of a needle that can vary in thickness from 14-24 Birmingham Gauge (a bizarre measurement system originating from the 19th century British iron industry) where the lowest number describes the largest diameter and therefore the most fluid can be administered per minute. In practice, it is usually referred to as ‘a blue one’ or ‘a pink one’. The needle is wrapped in a plastic sleeve that, after puncturing a vessel, is partially pushed into the blood vessel and can be connected to an infusion system. Contrary to what some patients who anxiously keep their IV arm still think, there is no needle left in your arm.
The act seems trivial until it fails. A wacky two-year-old toddler with a blood poisoning in which no vessel can be seen or felt. A patient with severe burns and only a few vessels left on a small foot are an option. And above all, for us as surgeons and surgeons-to-be, the necessary access for a critically ill patient with a gastric perforation or a burst artery that we really prefer to operate after he has been put under anesthesia by means of intravenous medication. Then, even though we don’t like to admit it, the anaesthesiologists are the real craftsmen.