We were met at the front door by an elderly woman. She was a hoverer. You know, the type of person that hovers around you looking over your shoulder. To make matters worse, she was a nurse.
As she led us down the hallway to the bedroom she gave us a good report. She had last seen her husband a couple of hours before when he went down for a nap. He had had a good breakfast and they checked his sugar afterward. When she found him cool, clammy and unresponsive she knew immediately that his glucose levels had dropped.
While we continued with our assessment AMR showed up. I heard the wife in the background saying that the only place to get an IV was in his thumb. The problem was that the thumb in question was not really accessible in the position he was in. That and the vein really wasn't that good.
While the AMR medic went for a line in his right hand I went for one in the left. Wouldn't you know it, just as I advance the catheter the unresponsive patient jerks his arm. I committed a rookie mistake and wasn't ready for it. I lost the vein.
The AMR medic glanced up at the patients neck. He had great jugular veins, just like the one in the picture. I stabilized the head while she went in with an 18 gauge needle. Then the old RN started in on us again. "You're going for the jugular? What are the qualifications of the person doing that?"
We assured her that we watched the training video at least twice and that her husband was in good hands. The AMR medic then started the IV. We taped the line down and started administering some dextrose. Within a few minutes my patient was having a conversation with us and was being told not to move his neck too much.
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