#i aspire to try and teach y'all medicine but i don't know much myself beyond drugs i just like to pretend i do

[raposarealm]

A break from the disastrous Kimochi, because I feel like crap! And what better way to distract myself from feeling sick than to talk about a sick boy!

Not the Yuyoyuppe album, this but this specific scene from Axess I’ve meant to rag on for a while now, from Episode 50.

(A read more for minor spoilers, I guess. And also because this got hella long.)

You might remember this as being right after the final fight versus Dark Blues, and also after the stupidest stunt the egghead pulls all season, which lands him in the hospital. 

First off, I’m going to bitch about this shot for a second:

(Credit to @panningexe​ for these shots, by the way, because I physically cannot bring myself to rewatch Axess.)

(This would be a good time to add in a disclaimer: I’m not a nurse or other medical professional, I’m a pharmacy technician who still doesn’t have her license in this state because I’ve been too busy to take the PTCB test. I did some preliminary research for the stuff beyond the pharmaceutical aspect, but most of that was just ‘stuff I learned from my mother who was an RN 20 years ago’. Take the finer details with a grain of salt, and please correct me where I’m wrong.)

Series never get medical things right, but, shockingly, that IV line is correctly set up. Taping down the extra line isn’t usually done from what I’ve seen, but it’s not wrong. Tangled lines are more of a danger, as long as the taped lines there are still loose enough to not impede the flow rate. But. You want me to believe this is a patient in critical condition, in a hospital in a large city, in the future, and all you have to regulate flow rate is a roller clamp?

But Rapo! you say, clamps can be used along with other regulators! Yes, but, lemme direct you to this other shot from the same scene:

It’s harder to see here, but: there really is just that one roller clamp and the drip chamber built into the line (which doesn’t really regulate drip rate well on its own.) Yeah, those work just fine, but they’re harder to use, and are therefore more prone to human error. Hospitals are already phasing them out, like, in real life. 

There’re two LVP bags (Large Volume Parenteral bags, large amounts of sterile fluid used usually for regulating essential bodily functions,) on the stand there. If I remember the episode correctly, Enzan was out of commission for multiple days following his dumb stunt, but I don’t remember how long he was unconscious. 

Quick rundown of some common LVPs for context: Normal Saline contains sodium chloride (usually 0.9%, but treatment of severe dehydration and NPO/’Nothing By Mouth’ patients often receive 0.45% instead,) is used on nearly everyone who’s admitted to the hospital, since it’s used to help with dehydration, and especially on critical patients and those with blood loss (and is sometimes co-administered with blood products.) Also containing sodium chloride with other compounds are Ringer’s Solution and Hartmann’s Solution (also called Ringer’s Lactate.) Both contain other electrolytes (calcium chloride and potassium chloride are pretty standard, for instance,) but Ringer’s Solution contains sodium bicarbonate in place of sodium lactate (hence “lactated” Ringer’s.) When high sodium is a risk, such as with renal impairment or some chronic conditions, or when a patient’s body is especially acidic, such as suffered with sepsis, then Ringer’s or Hartmann’s may be used in place of saline. (Source because it’s long.) Lastly, Dextrose 50% in water, usually abbreviated to D5W, can be used when the body is malnourished. Note that these might have to be switched around depending on the SVPs (’Small Volume Parenteral,’ or just normal medicine that’s injected or otherwise administered parenterally) given, e.g. nitroglycerin and norepinephrine, medicines used in cardiac emergencies, can’t be used with Hartmann’s. 

Side note over. Anyways, there’s only two bags present on the stand there, and the line’s only attached to one. Sometimes LVPs can be used to keep an IV line open while no medicine is being administered, but. This is, again, an unconscious, critical patient. From the first picture, we can see bandages on both Enzan’s hand and head, which I’ll guess are probably burns from the forced Fusion attempt (he was holding the PET and smacked into Blues head-on.) Burns are one of the worst things to treat, as they’re excruciating for the patient. Plus, there’s a chance that said head-on impact could’ve cause some head injuries. Why isn’t he on pain medication? A conscious patient can take medication orally, but that’s kinda hard to do when someone’s out cold. Burns carry significant risk of infection, too, and IV anti-infectives are often injected into the LVP bag directly, or ‘piggy-backed’ onto the IV line, which requires them to be placed on the stand higher than the LVP so that gravity pulls the piggyback medicine into the main line. I don’t see a connector on that line, but I suppose the medicines could have been injected directly. However, due to the manufacturing of that type of bag, there’d be a stopper on it to keep sterility, which maybe it’s there, but I don’t see it.

Also, can we take a look at the rest of the room? WHY ARE THE MONITORS OFF?!!? The only time you shut those things off are when you take someone off life support. That’s why hospital halls are filled with those annoying ‘bing’s -- those monitors have to be there. You never know when someone who looks stable suddenly become tachycardic. You never know when someone’s IV line fell out and now they’re not getting the medicine they need. You get the point. Not only are those monitors not connected to Enzan there, they’re not even on! For God’s sake, the closest he has to a monitor right there are Anetta and Netto standing next to him! 

As side not that I don’t know how to work into the rant, I’d say I’m surprised he’s not on oxygen, not even the nasal cannula you’d see in every soap opera episode that takes place in a hospital. I had one of those in for a sleep study, for God’s sake. But, since this is a medical device that I wasn’t actually taught about because my class sucked, I’ve now been informed that cannulas aren’t used unless the patient shows explicit difficulty breathing, but doesn’t require intubation (endotracheal tube, AKA tube down the throat,) or mechanical ventilation (partial or complete respirator.)

It’s nearly 1am and I’m done ranting, but TL;DR, if I lived Akihara, I’d have sued this hospital by now.