Saturday, May 11, 2019

Overhead IV Racks Done in by IV Pumps and Controllers

An overhead IV rack in it's safest position-on the ground
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Imagine a device that would take advantage of unused vertical space above the patient's bedside and free up congested floor space. Sounds too good to be true?  Well, it was.  In the early 1970s a new fangled device came to our fancy new state of the art ICUs. Designed by architects with decades of office sitting experience, but loathed by nurses at the bedside, the wonderous new creation was overhead  suspended IV hangers.

The ceiling was equipped  with tracks that ran around the periphery of the bed in a semi-circle or as a single diagonal running from the foot to the head. A looped hook with ball bearing wheels roamed the confines of the track. The IV rack  had a pigtail like structure at it's upper most  point  that was carefully threaded through the hook and you were in the  business of IV bottles in the sky.

These clever contraptions utilized a release button that dropped the rack down to working level that just happened to be the height of the average bedside nurse. It was fun and games for all until  a spontaneous release that dropped the loaded rack in a nondeviating  path on the top of a vulnerable cranium below. Talk about Excedrin headache #47, that really smarts. I think overhead IV racks may have been the impetus for semi-private rooms. A nurse was concussed by an overhead IV rack and rather than open another hospital room, an additional bed was wheeled in for the traumatized practitioner.

Another problem with overhead racks was a phenomenon known as "uplifted bottle drift." My recollection of high school physics is a bit fuzzy, but one of the facts of inertia included the notion that once a body is set in motion, it stays in motion. A sudden lateral adjustment of the heavy glass bottles position in the ceiling track sometimes meant the contrivance flew past it's intended stopping point resulting in a most unpleasant crash/bang with light fixtures or anything else in it's path. Twin overhead racks over a single bed were an accident waiting to happen. If both loaded racks collided, a shattered glass shower was inevitable as the bottles self destructed. If you think cleaning up glass IV bottles from the floor is bad, you haven't seen anything, as an occupied bed full of injurious glass shards glass was far worse. A two for one deal of the supremely noxious variety as both nurse and patient were potential laceration victims.

Gravity was a dependable vector to deliver IV fluids, but there were lots of variables when the only controlling mechanism was a roller clamp. This necessitated endless fiddling and adjusting as vascular resistance varied or the fluid level in the bottle dropped. See-sawing IV drip rates were always explained by that ubiquitous "P" word. Positional covered lots of possibilities from the position of the IV catheter to the movement of an extremity.

A revolutionary development appeared in the mid 1970s. Fancy little IVAC machines with glowing electric eyes plastered to the drip chamber began appearing. This clever little apparatus accurately controlled pre-set drip rates. Older nurses thought they would never catch on due to their expense, but to me, they were magic in a box. IVACs and the even more sophisticated pumps that followed required an IV pole for support. IV poles meant the death of overhead IV racks. We did keep a couple of the flying IV racks on the unit because a few of the patients enjoyed posting family photos or inspirational slogans on the overhead racks. It was a genuine boon to patient morale to look up and see a reassuring image and some of the hazards of these racks was mitigated by the absence of heavy bottles.

If you are interested in acquiring an artefact of nursing/hospital history, there are loads of these fickle firmament flying fixtures for sale on EBAY. Just don't forget to duck!





9 comments:

  1. High flying IVs ended my bedside nursing career. Indeed, they were a hazard to be reckoned with.

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  2. Yikes, I've never heard of these things - they sound downright dangerous! I don't know if they ever made it across the Pacific to Oz but I'm glad I never came across any! Sue.

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  3. I remember the hangers... I hated them too ! Ever seen/heard the crash of a full bottle of Lipids? NASTY!!!

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  4. Intralipids and albumin have to be two of the nastiest IV solutions to clean up after a bottle break. The whiteish opaque nature of lipids tends to camouflage trauma inducing glass shards. Glass IV bottles make their own horrible unique sound when they break. That crack followed by the swishing noise of an expanding liquid pool of fluid is one of the memories I would like to forget.

    On evening I was caring for a patient who was watching that 80's classic TV show, Miami Vice. I was not paying much attention to the show as I was occupied with milking his chest tube. I jumped out of my skin when I heard that bang..glass breaking..fluid gush noise of a shattered IV bottle. Thank Heaven it was a scene from Miami Vice where someone shot out several huge aquariums.

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    1. That gave me a laugh OFRN! Sue

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  5. It is completely plausible that you really have stated the reason for a semi private room. It seems quite logical.

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  6. Semi-private rooms are really semi-public. I can understand the public's acceptance of this when the room rates were $70.00 per day back in the stone age when I was a nurse. I can't imagine anyone paying $650+ per day to discuss there bowel and/or bladder maladies with a stranger several feet away. Someone should invoke the often cited HIPPA law. I cannot think of a more egregious violation of personal privacy than two vulnerable patients lying just feet away from one another revealing their intimate secrets.

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    1. Worse than that we now have mixed gender wards in our hospitals OFRN - men and women in the same 4 bed room. Legally women are only supposed to be placed in the same room as male patients for a maximum of 48 hours but in fact it goes on for longer than this and most women especially hate it. I think it's a disgrace.

      All the obstetricians/gynaecologists at my original training hospital had a protest meeting about it with the Director of Medical Services (ie. Head Honcho of the hospital) to stop it happening but to no effect (and the Medical Director was a woman).

      Unheard of in my day... we would have been horrified. Sue

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    2. Wow! I bet the privacy curtains get a work out. Truth is stranger than fiction.

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