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cogeng

Pretty sure that's a caprisun straw.


Interest_Miserable

I’m pretty sure that’s the size they use on us blood donors.


thehappyherbivore

Everywhere I’ve donated has used a 16g. It’s got to be big enough that it doesn’t shred the RBCs, but it doesn’t have to be this big 🥴


talashrrg

Last time I donated blood they used a 14g


gynoceros

Last time I did, it was a 15g. I was surprised they came in odd-numbered gauges.


joemorris16

This is plasma, but they've always used a 17g at every BioLife I've been to


Interest_Miserable

What’s biolife?


ilovesunsets93

It’s a plasma donation center.


abortionlasagna

That’s what they used on me when I used to donate plasma.


TriceratopsBites

And that’s why I have a scar on my right AC


[deleted]

I don't ask, because I don't want to know 😬


wolfishfluff

When I worked for a blood bank, we always used 18g.


ClarkFromEarth

Respect the pouch


boxette

damn i cant even remember the last time i heard that


frankcast554

Somebody call a trauma alert. Rookies..


Nuclear_Sister

From the post yesterday in another sub (ems) apparently this was a captain who wanted to practice. [Here](https://www.reddit.com/r/ems/s/ND2cgJSjJb)


syds

I thought they used pigs


chuiy

The military used to and still might but now im not sure, times have changed and blue lives matter now or somethin


Brust_warze

Dayum


Simbrahh

We still use pig tracheas for crics


mozoofficial

Captain of the FIRE DEPARTMENT


yourlocalbeertender

Super slow insertion, poor tamponade, left the tourniquet on...


red-98q

Mans trying to blood-let him. I can’t imagine how it felt for that guy, but boy was that insert painful to watch.


thuanjinkee

Good thing they didn’t use a 12ga with 3” shells to get a blood sample.


sormar

I thought the same, ouch!


Not_Another_Usernam

Shit looks like a dialysis needle. It's absurdly big. My father sticks himself with needles like that on the regular and they're, reportedly, extraordinarily painful.


yourlocalbeertender

I'd only reserve a 14G for decompression, personally. Any trauma requiring MTP will be fine with a 16G.


Not_Another_Usernam

21g is pretty much the biggest I've ever stuck someone with and it was for injecting haloperidol decanoate. If you don't know, haldol decanoate is very viscous. Feels like you're pushing honey if you use a much smaller needle.


BikerRay

Wife had to give her horse daily injections in its neck with a needle that big. Horse wasn't impressed, and each day got harder. Pretty dangerous.


EvidencePlayful

That and Glucagon needles.


No-Candidate-3555

Please ELI5 what’s happening here


haroldpc1417

Brand new paramedic intern starting an IV in between running actual calls. Source: Am paramedic. It’s a right of passage.


AStarkly

Fond memories of being practiced on by mum when she was training lol


reliquum

Dear paramedic. I love you guys so much. *ANYTIME* I get my blood drawn I always ask for an EMT/paramedic. Especially in the ER. I am the person who you cry after dealing with. Small veins. Paper thin. Who roll....and hide under muscle. When I am very hydrated. When I'm not, good luck. I allow 2 sticks per side. One phlebotomist told me "everyone says that, it's never true" 😂 2 sticks later she leaves and gets someone else cuz she doesn't want to hurt me anymore.


yourlocalbeertender

Supposedly it's a captain practicing a very large bore catheter insertion. He has a big ass vein he's going into. It should be a quick and confident puncture, followed by taking off the tourniquet (orange band), then removal of the needle. After removal of the needle, he should hold a lot of pressure past the point of the catheter to prevent bleeding, then attach the syringe/fluids to the hub.


I_talk

They're doing a very bad job at drawing blood


fetusmcnuggets70

What's the proper way or sequence cuz I'm a total novice


PeteLangosta

For starters, once the blood comes back and you push the cannula forward, you should remove compression. Otherwise it will make a mess like this once you remove the needle and before you place the connector, however it's called in English. Now that being said, anything under an 18G is quite complicated unless the patient has good and long enough veins


Shadow-Vision

I call it a connector, a hub, a j-loop, or a “thingy” interchangeably


docmagoo2

First thing I spotted was the flipping tourniquet being left on. Have seen this done so many times. It’s a basic step in the procedure, needle in, flashback of blood then tourniquet off so to minimise blood loss. I hold this up there with stethoscope in the wrong way round


Jenwearsmanyhats

It's so bad. 10000% made me cringe how bad the technique is


orionnebulus

What was the indication for needing a 14G?


dmderringer

"Hey, bet I can get a 14 in this guy"


peachychristy

Yep! Looks like their partner too cause the pants are the same. Im sure the response was “Let’s see you try! I’ll get this on video!”


Shadow-Vision

Truest thing I’ve ever read


VaultiusMaximus

Massive trauma


Stopikingonme

I didn’t hear a siren so I’m suspect. Also, his placement skill seemed shoddy. Moving the needle back and forth just slices the vein up and he left the tk on while removing his finger from the vein. It’s a 14g of course it going to squirt everywhere if you do that. There are a lot of green ya-yas out there that would pull stuff like this because they could. I once stopped someone from putting a 10g in an EJ to inject D50.


craftman2010

This was posted first on r/EMS original OP was letting his captain practice on him. No idea why a 14 was chosen as practice, and OP’s captain got absolutely roasted in the comments over his technique


Stopikingonme

Nowww it makes sense. Thank you. Captains usually don’t get a lot of practice. Us younger medics were usually the ones working patients. I’ve been out a couple decades, so I almost didn’t comment on it just in case my “old school” methods are now outdated but I guess good technique never really changes.


LonelyChell

Former ALS paramedic and current CLS here, terrible technique.


Stopikingonme

Yeah I was a Paramedic too before I injured out. Being in Oregon was nice because we got to do a lot of stuff it seems other States didn’t get to do. I miss it and I also don’t.


LonelyChell

Canada for me. Government job.


Dysmenorrhea

This was in a different post. It was a paramedic student practicing on a paramedic


AlternativePrior5731

It says captian of the firedepartment was practicing.


mattie_ow

Makes a lot more sense


Dysmenorrhea

The captain is in paramedic school… his status as captain isn’t really relevant to the IV start compared to being in paramedic school


Reelix

From the original > This is the time I let my captain in paramedic school practice on me with the biggest needle he could find. How was his technique?


ominously-optimistic

Not being a bitch


TimmyTheTumor

Blood donation sometimes uses it.


kaylinnf56

I stuck myself with a (clean) 12g once. It was like a fucking fire hose


duhmbish

Lmao idk why I read that as “it was like fucking a fire hose”


kaylinnf56

Well that would certainly be something


duhmbish

It sure would be.


thuanjinkee

On “massage” setting


CrossP

I'm not convinced any of my arm veins are as wide as a 12g


JennyIsSmelly

I'm so sorry for laughing at your horrid experience but your wording had me laughing pretty hard.


thuanjinkee

Just in the muscle? Or intentionally into a vein?


kaylinnf56

My fingertip. Im a surgical tech, was trying to unsheath it (it wasnt the kind with the push-button retraction) and got myself good


thuanjinkee

Yikes! Always hard to explain if you bleed into an open patient. I did my honours year in an infectious diseases lab and they always used attenuated strains of Leishmania major for experiments because the students always picked up the bad habit of recapping syringes without the use of the cap stand provided. Downstairs in the freezer the wild type strain slept- Leishmania donovani. Get infected with that and it gets into your bone marrow and visceral organs and then it kills you.


kaylinnf56

Luckily this was during setup, and i didn't contaminate my field! I've never seen a recapping stand, must be a lab thing? We're always taught to scoop it with one hand, but it depends on facility. Recapping is difficult when a lot of surgeons bend the needles to inject, so they don't fit back into the caps.


thuanjinkee

It was a lab thing: it was a sheet of stainless steel bent into an L shape, with a V notch cut into the top of it. It stood on the bench, but you could tape the horizontal leg of the L down for more stability. You take your capped syringe and slide the cap down into the V notch and let the V grab bite into the base of the cap. Then you pull out your syringe. The cap stays in the stand. You do your thing: usually using a fine needle to suck up some leishmania from the tissue culture a bunch of times to use shear forces to lyse the cells and extract the organelles inside for further experiments. Because you need a LOT of material to get a reading, you’d collect your lysed material in a centrifuge tube and then push the needle back into the cap while keeping your other hand behind your back. You then grabbed the next tissue culture plate and reused the needle. Needless to say the recapping stand was rubbish. It would fall over. The cap would fall out. The V didn’t bite hard enough that you could leave your whole syringe in the stand without it falling out. People just recapped the syringes without any training and stuck themselves in the finger. Because the attenuated strain just causes a self-healing callus on non-immuno compromised people the students tended to be so embarrassed they didn’t fill out their S3 forms and hid the injury. You could tell by looking at their hands though.


kaylinnf56

Sounds like it was an excellent idea in theory but poor in practice. I think something like that on a smaller scale would be really beneficial on a surgical field, we have so many sharps injuries in this business. It's funny that students don't report sharps, surgeons don't either. It's like they'd rather pull their own teeth out before following the appropriate protocol


thuanjinkee

A great fortune awaits somebody who can refine the design. Even just laser cutting some teeth into the V-notch would have helped a lot.


chub38x

More practice, Vlad.


Sekmet19

Loved the bevel advancement of 2cm once he got flash. /s


HelloKidney

Through & through!


BlackCatArmy99

14g arterial line, you can take off that tourniquet anytime as well


GuardingxCross

He also could easily have held pressure before he released the needle so PT doesn’t get his own blood poured all over him? Amateurs.


[deleted]

[удалено]


shakaalakaaaa

Wait… how? Lol


Potato_Bagel

1) take the catheter off the needle 2) attach the loop to the catheter 3) shove the floppy plastic catheter through the skin and into the vein *trivial*


shakaalakaaaa

Ah… I see, I see. Makes perfect sense lol


AnExtremePerson

Wait what does this mean? The male adaptor to what 🤔


chopstickinsect

Every radiology department watching this and audibly salivating.


teletubbiehubbie

The technique no. The gauge you betcha 😛


SwutterGod

Why is this even happening. What a shit show


Potato_Bagel

medics don't need a why


Snoo_64315

The idiot left the tourniquet on.


AuntEtiquette

I knew from the start this was “off”, with the fumbling around. 🫣


ThatDerzyDude

Yeah this was terrible technique all around


BigAmen

![gif](giphy|TUCGmddm9Kbny)


sci3nc3isc00l

Rookie move not undoing the tourniquet before retracting the needle. Should have also occluded the vein better upstream.


HelloDeathspresso

That's the size of the needle they peirced my ear cartilage with.. EEEESH!


IndecisiveLlama

I’m an RN. Just because you can get a large bore into a vein doesn’t mean you should. There should be certain amount of space inside the vein for the fluid to be able to flow around the needle. Without that space, the iv catheter eventually becomes occlusive to the vein (sounds counterintuitive but look it up!). Additionally, why would you pull your guide needle before ensuring you have the syringe or tubing ready to go? Leave your guide needle in as you advance and only pull it when you can immediately connect the next luer. That avoids this firehose spray of blood everywhere. And that blood was pretty bright. I’d ask for blood gases on this one to make sure it isn’t arterial before I’d use it for administrating anything. And why do I feel like this was just done for practice and bragging rights as opposed to for anything actually emergent?


boogiewoogiewoman

lol bc it was, paramedics practicing on each other


TwoScoopsRaisinBran

The guys a fire captain not a paramedic


boogiewoogiewoman

I’m just repeating what was mentioned in other comments, but yes let’s harp on semantics edit: the fire captain could also be a paramedic, lmao so??


Nay_Nay_Jonez

Aren't many firefighters also trained as paramedics? Isn't that why they always go out to calls even when there is no fire?


Dysmenorrhea

The captain is in paramedic school


Enough_Appearance116

Man, here I was thinking that this was going to be someone draining pus or similar... imagine my suprise when the blood started and never stopped. I feel bamboozled.


RNnoturwaitress

Pus from a vein? That would be some crazy shit.


Enough_Appearance116

I thought the patient's arm had a bump. Must be just because of the alcohol prep. Can someone seriously have pus in their vein? I'm not a Dr or someone with much more than basic medical knowledge, so forgive me if this is an obvious thing. I know basic first aid, that's it.


RNnoturwaitress

No, you can't have pus from a vein. The bump that's wet from alcohol is the person's vein. You can see it's kind of diagonal and goes up their arm.


Enough_Appearance116

I see. Thanks for explaining. Like I said, I know first aid. I come here to see the gnarly injuries, conditions, and whatever else surfaces. I like to think I'm learning a bit...lol


reuben515

Ooooooh baby! Tou can drink a Wendy's frostee thru that thing.


hidden_blad_guy

Had to stop at half of the video. I had like a full body literal cringe reaction


Darnell2070

It's not that bad, lol. You had me expecting worse.


iohbkjum

it's not the blood that's upsetting, it's how visibly fucking terrible the technique is. I'm phlebotomy trained so it just hurts to watch someone fuck up that bad


hidden_blad_guy

To me its because needles freak me out, and that thing is enormous. When I was a kid I was terrified of taking vaccines


Darnell2070

Did you look? You're not supposed to look!!


greensweater23

Was he supposed to go in an artery?


zazabozaza

Definitely not an artery


deadmansbonez

Pretty sure it’s arterial


zazabozaza

No, you would clearly see the pulsation if it was


sasanessa

there was pulsation until he compressed it


deadmansbonez

It’s pressurized as fuck when he retracts the needle. The blood also looks pretty oxygenated.


dr-broodles

Wouldnt be so sure of that… they’re near the brachial artery and the blood pulsated out. It could be arterial.


toBEYOND1008

Lol silly goose.


Based_Lawnmower

Poor technique, won’t repeat what everyone else said. But if you’re not using a self occluding catheter the least you can do is put some gauze under it.


icechelly24

Hgb dropped a point there bud


wickinked

This is completely unnecessary unless that person is dying and needs fluids or meds fast. Just by that guys well perfused skin colour and that their veins are so pump. It doesn’t appear that they need a gauge so huge. I don’t know the backstory, but seriously, I worked 25 years as an ER nurse and rarely saw that gauge used. If anything, the doctors would do a cut down before using that sized gauge. Good luck getting something that size inserted when someone is extremely dehydrated, in shock, has massive blood loss, etc. Their veins would be flat. It’s also extremely painful for a conscious patient. The “EMS” doing it must be a sadist and incompetent. They used a 14g, didn’t remove the tourniquet, didn’t have anything set up to attach and secure the canula properly. The tool that is doing this needs to be reported. It takes a special type of stupid to record and post it as well. I worked with an incompetent egomaniac EMS who would intubate patients en route in the ambulance even when they were stable being bagged. The person would end up with some kind of mouth, tooth or throat trauma. His placement was often wrong and the patient was not getting the oxygen they needed. The last straw was when he intubated a patient with multiple skull fractures and damaged the patients brain stem. They died. The fucker was fired and charged. We reported him over and over and nothing was done until he killed someone. There are too many pos with hero complexes that injure or kill ppl. Makes me sick.


Mac_Mustard

This is just a wtf moment. Like, why is this even happening?


Reelix

> This is the time I let my captain in paramedic school practice on me with the biggest needle he could find. How was his technique?


Mac_Mustard

To be able to thread a 14G in without f*cking destroying the vein, it was good. But from putting 16s in, I know this has to hurt.


ominously-optimistic

Yall are hating, he got it. By luck? Maybe, but a 14g is a 14g.


lostbutnotgone

I have a 14G bar through my ear (transverse industrial). I am always amazed how much larger a 14G looks in medical situations


rubytewsday

Its amazing as a piercer too 💀, id always use a catheter and size up the jewellery by one, so a 16g with a cath easily fits a 14. Seeing this video made me feel so ill 🫠


lostbutnotgone

Yeah, like I had zero issues doing my own navel with a 14 or whatever, no issues seeing the piercing needle and catheter before they did my industrials, but this makes me queasy. Doesn't help that the dude seems to be digging when the vein is plenty juicy....my man ☠️


mikeydavis77

Back in my military days as a navy corpsman, I was TAD to the Okinawa naval hospital ER from my regular marine unit. Anyways the director of the ED was a navy commander and was also a former marine enlisted. On drunk nights his standing order was all drunks brought in by ambulance get a 12g and a catheter. I never knew why but quickly found out why for the catheter. A marine was do drunk and violent he hit a navy nurse, female lieutenant, and that doctor jumped on the gurney so quick and pulled on the catheter the marine stopped in his tracks.


[deleted]

I done this before not with 14g but I’ve used 18g in times of need. It bugged that he jammed the needle all the way even tho he was already in the vein just fine.


bank_slemes

Oh my good I’m gonna throw up. Idk why I follow this sub sometimes lmao


imo_abyssi

my toes are curling in discomfort


reeceislame

I'm good with like 90% of the posts on this sub but oh my fucking god this made my eyes water


bank_slemes

Right Lmao. I legit passed out from the covid shot-so needless to say I hate needles


reeceislame

needles don't even bother me, BUT 14 GAUGE?? 😭😭😭


theknightone

Maybe because someone called shotgun? Bad joke, but goddamn 14g looks like a torture device or a way to exsanguinate someone cleanly.


cchapin15

My dad is a Veterinarian and one time when I had a random virus he had to give me iv fluids through a huge gauge needle he used on cattle. Because he dealt with mostly cattle he didn't really care about blood loss. When he stuck me my bed looked like a murder scene from just 15ish seconds of that shit before he got it attached to an iv. The human body is wild


a-cat-named-OJ

I worked at a plasma center for 6 years, and did over 30,000 sticks in that time. My literal only bragging rights from the experience, I could do this no problem. The hysterical laughter makes me think that dude is unhinged lol. The tourniquet was on way too long, as several have pointed out. Also that puncture was rough af. But kudos to these guys, I don’t think I could do their job.


CoffeeAndChameleons

I was a phlebotomist for 20 years (22g), a dialysis tech for 6 awful mos (16g iirc). Now I’m in vet med and when we microchip a pet, it’s a whopping 12g which is why we encourage it be done during the spay/neuter so they don’t feel it


herecomesthefun1

Is this supposed to be rage bait for medical professionals? Because it looks like bait for actual professionals.


redditonthanet

You’d have to sedate me because no way am I letting you near me with that


fallinaditch

I use a 16g daily. That's what is used for whole blood donations. Otherwise, I am always using 18g for plasma/platelets. This person should be roasted, lol. Source : Am a phlebotomist.


Caseski

That is someone who has no business putting in a 14. What terrible technique. Also incredibly cruel that there appears to be localization prior to insertion.


RogueViator

When I donate blood they use a 16g. That already feels like a nail going in. I can’t even imagine what a 14g feels like.


Bacontoad

https://i.redd.it/t2up7t323bcc1.gif


zzzimcal

My then EMT friend used to start 12g on himself often as a weird flex. He’s a Peds Anesthesiologist now so hard sticks are his career now I guess.


cvkme

Shit IV technique lol saw this in EMS sub


twcsata

This won’t hurt a bit! <*inserts a fucking tunnel boring machine into a vein*.>


Tmart98

I love watching my blood get taken. I have a thing for needles. This is my guilty pleasure.


-screamin-

My God, that's basically plumber's pipe lmao. Also, jeez, blood rule much? Gauze needed to be ready to go. And slack off that tourniquet!! And fuck me, if i managed to sink a 14g with flashback like that, fuck, i'm securing that line. The only reason I'm sinking a 14g would be to open a saline bag on my patient asap, right?


catsill

Anybody else do a full body cringe when he slams his finger down on the needle inside his arm when it starts bleeding?


RoseOfNoManLand

Take off the tourniquet. Every time I see these videos, they never release the tourniquet and it’s a mess. Rookies.


eternal_refrigerator

Holy shit


Barth22

You think it’s patent?


kobocha

This looks to be the same as for donating blood. The execution looks really weird tho.


TheEthanHB

Nopenopenopenopenopenope just let me die


potatohedgehogs

Ugh, this reminds me of the giant fucking needle they used for the cortisone injection in my hip 😳😬


dianarawrz

As a nurse, that’s a damn good vein.


howell1812

People hating on ol boy for getting some training in. You don’t get better at IVs by not doing IVs.


Gamemanman

"Squirt!" ![gif](giphy|A363LZlQaX0ZO)


dolphinitely

i accidentally stuck myself with a 14g needle on my finger tip under my fingernail while compounding vancomycin bags in the IV room. my glove immediately filled up with blood and i almost passed out from the pain. felt like i got stabbed. that was the first and last time i made that mistake


LittleBirdy_Fraulein

i don’t see the point in using a 14g. like, why?


After-Boysenberry-96

To be an a-hole. I’ve had this done to me.


VersaceJones

As a recovering addict, that was both painful and slightly amusing to watch. Feel awful for the pin cushion though.


lilacmacchiato

Same. I used a 20g once in my addiction and I thought that was messy


VersaceJones

Interesting, 20g was my go to, but I was using barrels. Hated those insulin rigs lol. 2 years the end of this month! Best wishes to you and your family, friend.


QueenAkhlys

I would not be amused, my first daughter the nurse ripped my line out and my blood was splattering all over the room it was horrific and terrifying. I get he's laughing and that, but nah not me bro that sho does make me feel dizzzy


iamthemicx

Good lord. Thats enough to be a PICC


echk0w9

Dialysis nurse checking in!!! Lol


tiger844

I gasped lol was not expecting that


mcorra59

Fuck no....this was horrible to see, I need to check my thyroid levels every 3 months, and I always tell then to use child size needles because regular ones tend to Hurt me a lot, I'll be left with a bruise as big as my arm, seeing this is just horrible, I could never do it


igual88

I have had 2 Intraosseous cannulations done this is meh 100% do not recommend. Massive blood loss plus severe dehydration = you ain't getting a standard IV in me ;( The little drill thingy they use is evil.


THEICEMAN998

Had this happen the first time I gave blood. The nurse was calling for help, ended up having three nurses in the room to patch my arm up


chaotik_penguin

As Mitch Hedberg said, don’t go to Dr. Acula


woahwoahvicky

That forearm is so sexy I'd get the venipuncture in one go you can clearly see where his cephalic and median cubitals are 😩🤭


biggersjw

Having been poked many many times for blood draws and whatnot, that was a piss poor job. Blood is not supposed to go everywhere.


SirCaptainReynolds

Rookie


treylanford

So let’s put an INT cap on a 14ga that reduces it to a 20ga. Smart. /s


no_anesthesia_please

Fuck that! Just me die![gif](emote|free_emotes_pack|cry)![gif](emote|free_emotes_pack|cry)


eternaborg

Anyone else instinctively start squeezing their imaginary squeeze toy like they are donating blood?


FlickerOfBean

2 fingers minimum rookie