When a doctor writes an order for an IV, is he doing it for your own good or to cheat you out of your money?

Your child has a high fever. Give him an IV so he gets better quickly.

Intravenous infusion in outpatient clinics is just a scam. I would never let my child have an intravenous infusion.

Which of the above two statements do you think is right? I received a private message from a parent who was concerned about the issue of intravenous infusion:

Which side do you stand on in this matter? In the final analysis, this is a question of the indications for intravenous infusion.

As a parent, it is a good idea to be wary of certain unnecessary infusions , but completely refusing infusions is going to another extreme of overcorrection .

Infusion vs. No Infusion

According to the specific condition

For most pediatric diseases, such as the common cold, hand, foot and mouth disease, diarrhea without obvious dehydration, herpetic pharyngitis, bronchiolitis, etc., infusion is not a necessary option for treatment, does not speed up recovery of the disease, and increases unnecessary potential risks.

But in the case above, the child is vomiting and having diarrhea, and has lost a lot of water in the body, which requires vigilance. The child refuses to eat and drink, and there is depression when his arms are pinched, which meet the indications of moderate to severe dehydration, and intravenous infusion can be considered.

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According to the "Clinical Practice Guidelines: Maintenance of Intravenous Fluids in Children" issued by the American Academy of Pediatrics in 2016, when children are obviously dehydrated and cannot receive oral rehydration, intravenous rehydration with isotonic solutions containing appropriate amounts of potassium chloride and glucose can significantly reduce the risk of hyponatremia.

Hyponatremia can lead to an imbalance of water and electrolytes in the child's body, excess fluid in the brain, swelling and other nerve damage, and even death.

Considering the situation at the time, intravenous infusion is the most appropriate method of fluid replacement available under the current medical level.

Intravenous fluids carry risks

But it is necessary

The two magic weapons for outpatient treatment are commonly known as injections and medication.

When administered orally , the active ingredients are absorbed into the blood vessels by gastrointestinal cells and then transported throughout the body through the circulatory system to exert their effects at the site of the lesion.

In this process, the stomach and intestines form a protective barrier, blocking some drug excipients or impurities that cannot be absorbed . The stomach and intestines have a certain buffer time to absorb drugs, which also reduces the metabolic burden on the liver and kidneys.

Intravenous infusion is the process of injecting the active ingredients of drugs and a large amount of fluid directly into the blood circulation system, which delivers them directly to the whole body through blood vessels to exert their medicinal effects.

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However, drugs are never 100% pure, and intravenous infusion drugs and saline solutions are inevitably mixed with trace amounts of impurities , including plastic particles, rubber particles, crystal particles, fibers, dust particles, etc. If there are too many impurities, or if they encounter a person who is allergic to the corresponding substance, adverse reactions may occur.

This is also the reason why many doctors have always emphasized " take it orally instead of intramuscularly, and inject it intramuscularly instead of intravenously ". The latter two are not better than the former, and the former is obviously safer.

Compared with oral medication and intramuscular injection, intravenous infusion as a method of administration does have some additional risks. However, these risks are not so high that infusion should be abolished . In some necessary special circumstances, intravenous infusion has irreplaceable advantages.

What situations require intravenous infusion

Parents' Information

In short, there are three main types of situations that require intravenous infusion: one is when you can't take medicine, two is a special dosage form of medicine, and three is a critical illness.

Specifically, intravenous fluid infusion is reasonable if the following indications are met:

1. The patient is unable to take oral medications, such as being unconscious or needing to fast before surgery.

2. Severe absorption disorders occur, such as vomiting and severe diarrhea.

3. Some drugs are only available in the form of an infusion, or direct oral administration will cause damage to the digestive tract, so they can only be administered via intravenous infusion.

4. In certain situations where every second counts, such as severe dehydration, coma, severe burns, severe electrolyte imbalance and other "urgent" and "serious" conditions, doctors will inevitably race against time and give patients intravenous treatment according to the situation.

Many medical procedures are about choosing the lesser of two evils. When the benefits of intravenous infusion outweigh the risks, there is no need to reject it out of fear.

Fortunately, this kind of situation is relatively rare in normal times. Parents usually don’t need to worry if their children have a cold or fever, or are hospitalized for observation without critical conditions - just don’t give them intravenous drips.

True evidence-based parenting is about learning to think rationally, understanding the reasons behind medical decisions, weighing the pros and cons, and seeking the greatest safety for your children.

Back to the two questions at the beginning, now you have the answers, right?

Planning and production

Source: Dr. Ou Xi

Editor: Yinuo