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posted by janrinok on Wednesday February 28 2018, @09:04PM   Printer-friendly
from the you're-a-drip dept.

Would it be wise for many hospitals to replace saline with balanced fluids for hospitalized patients? It appears so. Doing such a move might significantly reduce mortality and morbidity, according to Vanderbilt University Medical Center's Matthew W. Semler during a presentation at the annual meeting of the Society of Critical Care Medicine.

The study involved 28,000 patients at Vanderbilt University who were given either saline-based IV bags or balanced fluid variants. They found that for every 100 patients on balanced fluids, there was one fewer death or critical kidney damage. Yes, 1 percent doesn't seem a dramatic reduction — but when viewed at a grander scale, that could mean up to 70,000 fewer deaths and 100,000 fewer incidents of kidney problems annually in the United States.

Source: http://www.techtimes.com/articles/222043/20180228/a-new-study-suggests-there-s-a-much-safer-iv-liquid-than-saline.htm


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  • (Score: 2) by tangomargarine on Wednesday February 28 2018, @10:45PM (8 children)

    by tangomargarine (667) on Wednesday February 28 2018, @10:45PM (#645456)

    The study involved 28,000 patients at Vanderbilt University who were given either saline-based IV bags or balanced fluid variants. They found that for every 100 patients on balanced fluids, there was one fewer death or critical kidney damage. Yes, 1 percent doesn't seem a dramatic reduction

    I don't suppose there's any chance that this new "balanced fluid" thing costs 3x as much per unit?

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  • (Score: 5, Funny) by Immerman on Wednesday February 28 2018, @11:14PM

    by Immerman (3985) on Wednesday February 28 2018, @11:14PM (#645477)

    Of course not.

    Nobody would be pushing it if the profit margins were that slim.

  • (Score: 2) by VLM on Wednesday February 28 2018, @11:54PM (6 children)

    by VLM (445) Subscriber Badge on Wednesday February 28 2018, @11:54PM (#645499)

    I don't suppose there's any chance that this new "balanced fluid" thing costs 3x as much per unit?

    I was bored enough to look it up at dixie EMS supply for you.

    $4.50 for a liter of saline

    $6 for a liter of ringers

    You want to see something weird, first of all saline IV requires a prescription but if you can get sterile water, its literally 0.9% salt. You can't use table salt because its got anti-caking stuff added but just think about that, pure saltwater is part of the medical racket. Another oddity is half liter bags are custom and rare so a 500 mL is like twice the price of a 1000 mL, thats the power of logistics, millions of liter bags shipped vs thousands of half liters suddenly twice the stuff costs half the price, in bulk...

    Now an ER visit to get a bag of ringers for dehydration will cost four digits at least, and even non ER it would be maybe $100 for the full service labor to hook you up. Its exactly like car repair, its $999 to find the correct bolt or spark plug or connector, while the bolt / plug / connector only costs $1 to replace, thats your $1000 bill. Your ER bill won't go up more than $2 or so per bag, which is kinda a rounding error.

    I had considered IV gear when going thru a medic phase. I go hiking in the wilderness, a lot, so I figured it wouldn't be a big deal to get and maintain the training and gear for dehydrated people (myself or family). Uh not so simple, as it turns out. Someday I will do a wilderness-EMT course but thats $500 and fifty hours minimum. Of course that covers a lot of extra stuff thats also a very good idea. Just saying IV is not like CPR where any dude can learn it pretty quick and cheap, its the full WEMT cert (after EMT-Basic) or nothing. Someday, in my infinite spare time...

    Dixie is the cheapest place I know of to get non-prescription first aid supplies. While I was still doing cub scouts believe it or not it was cheaper to buy real antibiotic ointment for training first aid than to use ketchup from the food store. Crazy. I have no connection with Dixie other than happy customer etc.

    IVs in the context of EMT licenses get doc-droppy because it varies a lot legally by state. Who knows maybe you'd be all good with just EMT-basic depending where you live. Likewise training. Where I live EMT-Basic is community college level and total cost is about $1100 including testing fees and everything. So... to be a good Samaritan out in the woods I'd need to drop like two kilobucks which is either really cheap or really expensive depending on how you look at it. Two kilobucks will buy your family a lot of training, and secondarily, gear, to avoid needing medic support...

    • (Score: 4, Interesting) by bzipitidoo on Thursday March 01 2018, @05:35AM (1 child)

      by bzipitidoo (4388) on Thursday March 01 2018, @05:35AM (#645619) Journal

      Don't be too sure that the price of a bag of saline solution includes the labor. But even if it did, it's still outrageously high. It's often over $300. ERs also like to throw in this so called facility fee, which might be to cover labor, but no one can really say for sure. Medical pricing in the US is so messed up and corrupt that no one, not even the health insurers, can explain it.

      3 years ago, I went to the ER 3 times, and received a bag of saline solution each visit, for $306 each. Then it got weird. Health insurance reduced the price of the 1st bag to $151, the 2nd bag to $64, and the 3rd bag to $27. WTF?! Shouldn't the same item cost the same each time? Took me a year to learn what I think is the correct reason. Wasted a lot of time arguing with health insurance call center flunkies. About half of them admitted they couldn't explain it. The others pulled explanations out of the air. One thought it was because ER service on the weekend is more expensive. Nope, the $151 was a Thursday, and the $64 was a Saturday. Another thought different drugs must have been added to the saline solution. Nope, nothing was added that way, and if any had been, they would have been separate line items, not bundled into the price of the saline solution. Still another tried to tell me the line items were meaningless and the real prices were set in a secret agreement between the health insurer and the ER that neither I nor he would be allowed to examine. Finally I learned that the prices of the line items are set by the level of ER care (1 through 5) they assign patients. At level 4, the bag is $151, and at level 3 it is $64. So how come the health insurer couldn't tell me that? I also learned from a medical billing advocate that at level 4, the bag is included in the facility fee, so that $151 was them trying to double bill me for that item. As if their rates aren't high enough, they just have to cheat too. Wow. It's obvious the excessive complexity serves to hide crap like that. Anyway, I decided the whole thing was academic, and I told them I did not agree with their pricing schemes, whatever the reasoning was, and refused to pay their prices. I paid them the Medicare rates of about $2 per bag.

      By then, they'd long since turned it over to debt collectors. I wasted time trying to explain matters to the debt collectors before I figured out they don't give a crap, they only want the money. Finally told them I would not pay and to never call me again. In hindsight, I should have told them that much sooner. There's not much they can do about it, now that medical debt doesn't much count against your credit rating any more. They could try to sue, but that's very expensive and might backfire on them by exposing their racket, so they won't, not for a few thousand. I really think good citizens need to pressure the medical community much more, by refusing to pay their ridiculous rates, if we are ever to see serious reform in the cost of health care in the US.

      Wouldn't surprise me if the price of this new IV liquid is set to at least double what they charge for the saline. Because it's new tech, you know.

      • (Score: 2) by VLM on Thursday March 01 2018, @09:34PM

        by VLM (445) Subscriber Badge on Thursday March 01 2018, @09:34PM (#646012)

        Finally told them I would not pay and to never call me again. In hindsight, I should have told them that much sooner. There's not much they can do about it, now that medical debt doesn't much count against your credit rating any more.

        I had a girlfriend who had the same experience with a broken arm over about $1000 oh probably a quarter century ago. With medical inflation since then that's probably around $20000 now for the same xray and cast. She claims to have said something like "Well, I don't have any money so you're not getting any money and the debt will fall off my credit report years before I ever get any money or need a loan anyway, so don't bother me anymore" and it worked.

    • (Score: 0) by Anonymous Coward on Thursday March 01 2018, @07:29AM (2 children)

      by Anonymous Coward on Thursday March 01 2018, @07:29AM (#645656)

      You were a den mother?
      ...or things have changed since half a century ago?
      ...or there is some kink that evaded my remote observations?

      -- OriginalOwner_ [soylentnews.org]

      • (Score: 2) by VLM on Thursday March 01 2018, @09:42PM (1 child)

        by VLM (445) Subscriber Badge on Thursday March 01 2018, @09:42PM (#646018)

        LOL treasurer and doing first aid training kept them off my back WRT not being an asst scoutmaster or whatever the official title is.

        Some of the den mother women were nuts; this is supposed to be for the kids, not a single mother dating program. My wife would come to meeting with me (bodyguard, LOL?) and still the den mothers would flirt with me, which deserves points for effort if nothing else.

        Boy scouts gets more political in the sense of small group politics not national politics as discussed here; I can't volunteer as a mentor for the programming merit badge because the scoutmasters little sibling who is also a programmer would treat that as a personal insult, etc etc.

        There is very little training at the national level for treasurer past the background check / safety stuff everyone has to take, you pretty much have to learn it yourself which is weird. If you're in direct leadership role or what to get the camping endorsement or whatever theres tons of physical and online classes, but scout treasurers make it up as they go along, unless its very recently changed...

        • (Score: 0) by Anonymous Coward on Friday March 02 2018, @07:02AM

          by Anonymous Coward on Friday March 02 2018, @07:02AM (#646244)

          asst scoutmaster

          When I was a kid, that was an Asst. Cubmaster.
          Though they've changed some things, I expect it still is.

          Boy scouts

          That would be where they start calling them Scoutmasters.

          the scoutmaster[']s little sibling who is also a programmer would treat that as a personal insult

          Life is politics.
          You don't have to go far before you trip over that.

          -- OriginalOwner_ [soylentnews.org]

    • (Score: 2) by Magic Oddball on Thursday March 01 2018, @09:14AM

      by Magic Oddball (3847) on Thursday March 01 2018, @09:14AM (#645690) Journal

      The true oddity is that while a prescription is required to buy Lactated Ringer's or similar fluids, it's not needed in most states to buy the tubing & needles required to inject it.