Director, Emergency Services, Bikur Cholim Hospital
Intravenous lines are common, but there is a misconception
about them. Often they are used to give fluids to patients
that in truth could drink just as easily and get the same
benefit. The lines cannot be used to feed someone. I do not
believe that the use of intravenous fluids before a fast will
help.
Sometimes a good vein is hard to find, or there is a need for
a large vein to put in irritating medicines. The solution is
a CVP line, which is an intravenous line put in the neck,
clavicle area or in the groin. This is where the large veins
are easiest to find. Here one can be fed through special
formulas, but this is not a routine thing.
Sometimes caustic medications must be given for people with
lo aleinu cancer. These people may have an
intravenous type line put in their upper chest. It may be
above or easily accessed below the skin. Strict sterile
technique must be used to avoid infection.
People with large amounts of fluid in their brains many times
have a tube draining it to their abdomen. They will have a
shunt which can be felt underneath their hairline.
Urinary catheters are very common, and these are tubes that
drain the bladder. One of the effects of aging is loss of
continence and these poor people are forced to carry their
urine with them in a sack draining from this tube. I find
this to be one of the saddest things about medicine. However,
this tube greatly increases the risk of urinary tract
infection and that can be dangerous, so one must realize that
sometimes these devices are unnecessary. If a person has a
blockage due to a prostate enlargement, or if they are after
a medical procedure, then there is an indication. But
sometimes, for incontinence these are more convenient for the
nursing homes while perhaps creating a dangerous situation
for the patient. Diapers are a safer solution, provided they
are changed regularly.
There apparently is a mumps epidemic in the UK and polio is
back as well. It is now back in the Middle East, affecting
Yemen and Saudi Arabia as well as nearby Egypt. Mumps is a
virus that causes a rash, and swelling of the salivary
glands. Polio is a disease that is spread through poor
sanitation and in swimming pools and can cause paralysis. It
is also a virus. Both diseases have an effective vaccine that
can prevent these diseases, and therefore we do not see them
in Israel or in the UK. On the other hand there still are
people within our communities who do not vaccinate their
children. Since we do not have very good treatments for
viruses, this policy of not taking the vaccine is playing
with fire.
I got a letter saying that chemotherapy may have dangers. No
surprise here. These drugs are so dangerous that they need
special disposal of the packages they come in, and they need
to be given with gloves on and attention to splashes. These
drugs after all are supposed to kill cells, and sometimes
they kill healthy cells (that is why some of these people
lose their hair) or cause other problems. But they also save
lives. For example Hodgkin's disease is now curable with
chemotherapy. Write me in care of the Yated.
A message from GlaxoSmithKline, sponsor of this
column. Glaxo makes the vaccine against hepatitis A. This
disease is less seen in Western countries, but in Israel it
is rampant. While not dangerous, it is terribly debilitating.
Get the vaccine and then you need not worry about hepatitis
A.
