Telemedicine-Guided: IV Access and Fluid Resuscitation
Telemedicine-Guided adaptation of: Establishing intravenous access for fluid and medication delivery, with lunar-specific considerations for vascular changes in low gravity.
Indications
Emergency medication delivery, fluid resuscitation, blood products, parenteral medications.
Contraindications
Avoid infected or injured area. Central line in coagulopathic patient requires careful consideration.
Equipment Required
Standard Equipment
IV catheter, tourniquet, alcohol wipes, IV tubing, IV bag, tape.
Lunar Medical Bay Substitutions
Standard plus: IV bag holder secured to wall (bags will not hang by gravity — attach to magnetic or hook mount). Pressure infuser bag (gravity drip will not work in 1/6g — bags must be pressurized for reliable flow). Pediatric tubing with flow control (no gravity drip).
Procedure Steps
Select site (antecubital preferred). Apply tourniquet. Identify vein. Clean with alcohol. Insert catheter at 15-30°. Advance catheter while withdrawing needle. Secure. Connect tubing. Confirm position by aspiration. Begin infusion.
Lunar Technique Modifications (1/6 Gravity)
LUNAR FLUID MANAGEMENT: In 1/6g, IV fluids do not flow by gravity — all infusions require pressure bag or electronic infusion pump. Verify pump function before critical use. Blood has different flow characteristics in 1/6g vessels (altered hydrostatic pressure). Peripheral veins may appear fuller due to cephalad fluid redistribution — use this to advantage for access. IO (intraosseous) as backup if IV access fails.
Telemedicine Guidance Points
Contact Earth Medical Relay (+1.3s delay) at these critical decision points:
Consult before central line placement. Report if >3 failed peripheral attempts. Consult for infusion rates in shock states.
Training Requirements
Medical officers: IV access proficiency. First responders: IO device training.
Possible Complications
Phlebitis, infiltration, infection, air embolism.