Mobile IV infusions... for hangovers

Nurses General Nursing

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Have you ever heard about in-home IV infusion to get rid of hangovers? This is an idea I started thinking about when I read about it being offered in New York, and because in personal experience it works well, but someone has beat me to it locally.

The basic idea is extremely simple. You call, talk to a prescriber (currently an MD, but they're looking for NPs) who asks you about your health history and symptoms, then a nurse shows up and starts an IV. They don't take insurance obviously; no one will cover this. It seems a little sketchy, like back alley medicine... but it's also pretty low risk if your screening is thorough.

Now, the NYC operation I first heard about is pretty slick but seems more questionable. For instance they have different packages you get to pick from, the highest of which apparently includes IV magnesium (it says "liquid magnesium"). Not sure how I feel about that.

Anyway, what do you think? If you were going to do this, how would you do it so that it was ethical? I have no intention of starting a competing business... but it seems like a brilliant way to make money.

Specializes in Infusion Nursing, Home Health Infusion.

I would have no problem at all doing this as long as I have a legit order and have all the information I need.I would do an assessment, allergy review, height and weight, and review the medications the pt is taking. I have given so much medication, TPN, blood products and IVF in the home, the home part of it does not bother me. All safety mechanism s must be in place though.

I have seen to many patients lives destroyed by alcohol misuse to be ethically comfortable promoting a therapy that is intended to offset alcohol misuse.

Nurse Leigh said:
Have you guys seen those "oxygen bars" before? You can choose flavored/scented O2 if desired. Very...weird.

Yes, I have. Almost forgot about those. They seemed to be some weird craze around 2005ish in my area and seemed to pop up everywhere...although I haven't seen any while driving around lately. I agree, from what I could see from the outside...the only way to describe them was 'weird'.

Specializes in Behavioral Health.
Been there,done that said:
Not a Little sketchy .. a lot sketchy. You are administering IV medication in a person's home. Order or not. You are administering IV electrolyte replacement. What then would happen if said person develops a lethal arrhythmia? Magnesium is nothing to fool around with.

Run that scenario by your malpractice carrier.

I'm assuming the people who run these businesses have , though obviously I don't know that for sure. HH nurses can hang fluids. There's a whole industry around home infusions for things like IVIG, abx, and chemo, and as far as I know those services generally offer hydration therapy. So, selling LR for hangovers would probably fall under whatever insurance those providers have.

I mentioned being uneasy about the IV mag in the OP. I'm with you on that, but it seems like the most common IVF is LR with vitamins.

LR is unlikely to cause hyperkalemia on its own (a liter has 4mEq/L), and there's some evidence that it will reduce a pre-existing hyperkalemia. The K+ content of LR is lower than that of the extracellular fluid in someone with hyperkalemia, so as you expand the ECF volume the two numbers average out (K+ concentration of ECF + 1 liter LR at 4mEq / new total # liters of volume) and total K+ goes down as potassium redistributes from ECF into the LR. Plus, since LR contains bicarb there's no pH shift that would lead to K+ leaving cells where it belongs.

Since hypercalcemia is relatively difficult to cause in people with normal renal and parathyroid function (unless the client is a long-term user of calcium-based antacids), that seems like a low risk that could be screened for. But then, that's also why nurses administer IVF, to check for those things.

Specializes in Behavioral Health.
Twinmom06 said:
I think that sounds heavenly after a nasty bout of gastroenteritis. I was so sick last March I passed out at work (3 days after the fact) and when they took me to the ER and gave me a bag of NS (along with 40 mEQ of K+ because my K+ was only 3) I felt like a million bucks

Yeah, the hangover thing aside, the idea of getting a liter of fluid brought to me if I were sick enough to be nauseous and unwilling to leave the house is pretty tempting.

Specializes in ER, Med-surg.

I wouldn't want to work at one of these places because a. I imagine there might be a tendency towards a certain attitude/age/entitlement level among the clientele and b. I would really worry about that one time in a hundred or a thousand that the "hangover" turns out to have been something serious and we're stuck in, basically, a very minimally-equipped lounge with a crashing patient who presented with all kinds of warning signs but was seen for their "hangover" anyway because referring people to the ED is the quickest route to angry Yelp reviews for your luxury medical business.

But if somebody else wants to run that risk and it keeps the merely-hungover out of the ED, awesome.

Dogen said:
Yeah, the hangover thing aside, the idea of getting a liter of fluid brought to me if I were sick enough to be nauseous and unwilling to leave the house is pretty tempting.

As long as the nurse is a good stick and brings coffee

Sounds great! Hit me up with a little 1/2 NS + K, B & Mg after my next 4 NOC stretch. Get some sleep, relax those wire tight muscles and no headache... Make up for the 16 hours I didn't get to eat, drink or pee...

ETA - I wouldn't complain if you threw in some IV Tylenol, but I'm not picky...

Specializes in critical care.
Dogen said:
Yeah, the hangover thing aside, the idea of getting a liter of fluid brought to me if I were sick enough to be nauseous and unwilling to leave the house is pretty tempting.

Prevention of ED visits for people who simply need rehydration and electrolytes might be cost effective and would open up beds to truly acute/critical patients, too.

Specializes in OR, Nursing Professional Development.

My facility might have a bit of a blackmarket business going on. I've seen on weekends where one of the anesthesia folks will come in and leave with an IV setup and a bag of fluids- with the claim it's to help their sick, vomiting, pooping kid. Not kosher in my view as they're stealing company property, but yeah, if it would have been possible to get a home hydration therapy when I was so incredibly sick that I became anuric from all of the fluid loss, I would have gladly paid for that instead of driving myself to the ER for more lab tests that I didn't need when all I needed was fluids.

Apples&Oranges said:
Sounds great! Hit me up with a little 1/2 NS + K, B & Mg after my next 4 NOC stretch. Get some sleep, relax those wire tight muscles and no headache... Make up for the 16 hours I didn't get to eat, drink or pee...

ETA - I wouldn't complain if you threw in some IV Tylenol, but I'm not picky...

No IV Tylenol, because liver.

"I'm assuming the people who run these businesses have "

Malpractice insurance perhaps, to cover the company. How would that cover the nurse? Is that not why hospital nurses have their own coverage?

You could also be "just" be administering IV fluids. Does the client have a history of CHF, ESRD, or cardiomyopathy? Flash pulmonary edema would not be able to be handled in this setting.

Those "easy bucks' are not worth the risk to your professional licensure.

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