I'm an intern. are there any helpful tips or suggestions for cannulation. Also i feel very apprehensive because I'd be pricking the patient n causing pain. Is there anyway to get over the apprehension, especially for the first few times. I have done it twice but always messed up. ( Too superficial, hitting a valve etc) . They just say it happens try again.. but I feel more anxious to try again and insist the pros do it. Thanks in advance.
Itâs essentially practice makes perfect. Ask if you can spend a few days in the pre-op area of your hospital putting IVs in people. Itâs going to suck initially, but the fake arms arenât going to give you much experience in the way of actual people.
Another thing you can do is try to put a few IVs in yourself (upper thighs work great) or have a nurse who does IVs all the time put a few in your arms. That way you know what they feel like and what you did and did not like about the experience, so you can incorporate that into how you do IVs.
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For about a year, now, I've been wracking my mind on the subject of the latest reconstruction of the extinct holocephalan[1] Helicoprion[2]. By all other accounts the latest reconstruction, which can be viewed below, is the best it's ever been. The iconic Eugeneodontid[3] tooth whorl fits into the jaw in a logical way and lends credence to our present understanding of its diet.
But, as you gaze further posterior, you may notice something queer: no pelvic or anal fins. Now, a not-insignificant number of living chondrichthyes[4] lack anal fins. This is not out of the realm of imagination. But the same cannot be said of the pelvic fins, which aid in control and stabilization and also serve as the girdle for which claspers are attached to in males. All living chondrichthyes possess pelvic fins; from chimaeras like Hydrolagus colliei[5], to sharks like Hexanchus griseus[6], to skates[7] like Raja binoculata[8].
(Hydrolagus colliei)
(Hexanchus griseus)
(Raja binoculata)
So, why are they missing in our latest reconstruction? I made attempts last year to reach out to the researcher responsible for our modern understanding of Helicoprion, Jesse Pruitt (whose lecture on his research set me off on this journey), through LinkedIn, but I never got a response. Looking through my message history, though, the conversation appears to have disappeared, making me wonder if I'd actually sent it at all.
This morning, I tried again. I drafted up my question and reasoning and sent it to Pruitt's LinkedIn and ResearchGate profiles, and I sent it to the Idaho Visualization Laboratory (IVL) which made the Helicoprion model. I had expected considerable delay, but to my mirth, I got a response this afternoon.
On behalf of IVL, Leif Tapanila responded to my email with answers. As it were, other Eugeneodontids from the Carboniferous and Permian periods were preserved better than our Helicoprion specimens. Specimens of Fadenia[9] and Romerodus[10] were preserved very well with full-body imprints in consistent shale rock.
(Fadenia)
(Romerodus)
These imprints lack pelvic fins. Considering their close relation to Helicoprion, this absence was assumed for the visualization. I've inquired after Edestus[11], another Eugeneodontid of the same era, since there are many specimens and imprints, however fragmentary. I have yet to receive an answer, but when I do, I will update this post.
(Edestus)
I was determined to find some oversight, since holocephalan specimens from the Devonian period include pelvic fins in their reconstruction, but it seems the facts have dissolved my suspicions. I wanted to share this with you all, since I cannot edit Wikipedia articles (much to my dismay, as I have learned much and more in my studies of H. griseus that I want to add to its page). This knowledge deserves to be shared, since I find it ponderous.
Until next time,
[1] Subclass of chondrichthyes, containing contemporary chimaeras.
[2] Extinct eugeneodontid. Etymology translates to "Spiral saw"
[3] Order of holocephalan characterized by tooth "whorls" and inability to shed teeth.
[4] Class of chordate (vertebrate) characterized by a cartilaginous skeleton
[5] Chimaera known as the "spotted ratfish"
[6] Hexanchiform known as "bluntnose sixgill shark"
[7] Order of elasmobranch "Rajiformes," adjacent to rays.
[8] Rajiform known as "big skate" (no, really. haha)
[9] Eugeneodontid from the Carboniferous, Permian, and Triassic period
[10] Eugeneodontid from the Carboniferous period
[11] Eugeneodontid from the Carboniferous period characterized by its scissor-like teeth and jaws.
When someone has a full tattoo sleeve does that make it harder to find veins for IVs and drawing blood and stuff like that??
Not necessarily. It will make it so machines like vein finders don't work, but since most of us find veins by feel instead of sight, they usually don't make that much difference.
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I thought I would get further into the plot than I did, but oh well. Have some Bailey being uncomfortable and confused while the heroes try to help them.
CW for minor medical stuff (starting an IV), medication, and Bailey's crappy headspace. Let me know if I missed anything, or if you'd like to be added or removed from the taglist.
Masterlist
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Bailey slowly managed to get their breathing under control. No matter how many healings they went through, they never got less intense.
They survived, though. They always survived. And they remembered to show their proper gratitude for the healing, too.
The healer double-checked their concussion, using a penlight to check pupillary reactions.
âConcussion is healed,â she said as Bailey blinked away the lightâs afterimage. âGood news! You can have painkillers now.â
âThank you,â Bailey said softly. Painkillers werenât something to take for granted.
She came over with a tray loaded with equipment. Bailey swallowed hard. Tourniquet, alcohol swabs, medications, syringes, needlesâwhat were they going to do to them?
The healer must have noticed Bailey staring, because she made eye contact with a soft smile. âIâm going to start an IV so we can get some fluids started, as well as giving you those pain medications. Okay?â
Bailey nodded quickly, cheeks prickling with embarrassment. There was no reason for them to be such a stupid little baby, are you going to start crying now? about this. The heroes were doing them a kindness. They needed to suck it up and deal with it.
They tried closing their eyes as the healer worked, but that made everything worse. The smell of disinfectant, the hum of the machinery, it was all too much like being back there. They opened their eyes. This wasnât⊠wasnât there. They got out; they were at Hero Headquarters now.
They got out.
The healer stayed focused on their arm as she asked, âAre you allergic to anything? Medications, foods?â She pulled the tourniquet tight and started feeling for a vein.
They blinked. âUh⊠not that I know of?â
She nodded. âGood. Because youâll need some antibiotics as well, just to make sure your back heals up properly.â She picked up a needle.
âOkay,â Bailey managed to croak out. They had to look away, but they could still feel the sharp sting as the needle pierced their arm and the strangeness as the tubing entered their vein.
âAnd⊠done!â the healer said. When Bailey looked over, she was taping the tubing to their arm and removing the tourniquet. âBring me a bag of saline and an IV stand, please, and theâyup, that one!â
That was directed to the hero, who was walking over with the requested items. They looked⊠surprisingly concerned. Yes, it was the job of heroes to care about and save people, but surely that didnât extend to villains, right? There was no reason for them to look so soft when looking at Bailey of all people.
âThanks, Foxfire!â the healer said.
Foxfire looked down at her and raised an eyebrow. âWeâre using codenames?â
âUntil our fearless leader says otherwise!â she cheerfully replied, undaunted by her colleagueâs glower.
Bailey rather wished they could disappear right then. Whether it be through invisibility, mimicry, or teleportation like Foxfire could do, they werenât picky. Of course the heroes knew each otherâs civilian identities. They would obviously use their real names in their own base. And here was Bailey, a villain, in their midst. They were forcing the heroes to abandon their usual easy dynamic and instead guard their identities in what should be their safe place.
âSorry,â they said, barely more than a whisper.
All that earned them was a strange, undecipherable look from both heroes.
The healer set the IV stand next to the bed Bailey was on and hung the bag of saline off it. She fiddled with a length of tubing, and then Baileyâs arm was chilled by the saline drip. She grabbed syringes and loaded them, presumably to inject into the IV. Bailey didnât watch.
âSo!â the healer said. âNext steps. Weâre going to photograph your injuries, and Iâm going to splint your leg. Then Foxfire is going to start on your back while I start the paperwork for all this. Any questions?â
Too many to count. And apparently the pain meds were kicking in and breaking down their brain-to-mouth barrier already, because they blurted out, âWhat paperwork? Why do you need to take pictures?â
The two heroes shared a look, which did nothing to calm Bailey down. They looked from Foxfire to the healer and back again, anxiety rising as they went long moments without answering.
âItâs for when we eventually arrest whoever did this to you,â Foxfire finally said.
Bailey almost laughed at that, but they still had enough self-preservation instincts to manage to keep that in.
âWe need as much evidence as we can get,â the healer continued. âIâll be writing down what all I healed; thatâs what the paperwork is.â
Bailey just nodded. It wasnât going to happen, but it was a nice idea. And the heroes had their protocols they had to follow. It would be stupid to tell them no.
Bailey squeezed their eyes shut against the flash of the cameras as the two heroes started photographing their injuries. They were quiet as they worked, only the occasional instructionâchin up, turn this here, lift that thereâbreaking the silence. The heroes were doing this to help, but it still felt like they were documenting a specimen they were about to dissect. Bailey felt small under their assessing gazes, like nothing more than an insect waiting to be pinned, numbered, and cataloged.
Finally, the healer nodded. âThatâs enough for now. Weâll need to ask you about these injuries, and get pictures of your back once itâs cleaned, but that can all wait. Iâm going to get the supplies for your leg.â
Foxfire perched awkwardly on a nearby stool as the healer walked off. They said, âYou know weâre not mad at you, right?â
âWhat?â Bailey asked dumbly.
Foxfire gave a smile like a wince, their lips pressed together tightly. âWe should have said that earlier. Iâm sorry. Thatâs on us; it wasnât our intention to scare you. Weâre angry that this happened, not at you.â
Bailey blinked at them. The words were a puzzle that they couldnât fit the pieces together. âBut⊠why?â
Foxfireâs face went through a series of expressions that Bailey couldnât follow. âWhy do we care, since youâre a villain?â
Bailey nodded. Their head felt fuzzy, like it was packed with cotton balls. Nothing was making sense.
Foxfire smiled again. This time the expression was sad. âNo one deserves to be hurt. Not even villains.â
They must have noticed Baileyâs blank incomprehension, because they added, âYou donât have to believe me. Itâs okay. But I just wanted to make sure to say it. This isnât your fault, and we arenât angry at you.â
