Autism, Chelation and Quackery

15 Apr

Mercury Mum, Christine Heeren recently posted a video of her son receiving IV chelation on YouTube.

UPDATE: Shortly after this blog post went live, the YouTube video disappeared. Luckily I had already grabbed a copy which you can view here:

http://video.google.com/googleplayer.swf?docId=-5984127405622843714&hl=en-GB

Its a disturbing video on many levels. Heeren’s son has been undergoing chelation for seven months now and is still clearly totally autistic. During this video he is apparently writing ‘bus numbers’ down. The blog that Ms Heeren keeps (link on YouTube page) also makes it clear that her son still stims and he displays many common outward signs of autism (the scrunching up of the eyes at the start of the video reminds me of something my daughter does very much).

Heeren is subjecting her son to the Buttar protocol which should give anyone the stone cold heebie jeebies in and of itself. One patient of Buttar’s said that:

I find that Dr. Buttar talks a lot but produces little evidence.

And another said:

All the information about Dr. Buttar is still on this site but I no longer am one of his patients and I do not recommend him to any one for any reason. If you go to him for treatment BEWARE, BEWARE and read Roger Mason’s books first and go to QuackWatch.org first!

However, maybe we should take some kind of solace from the fact that Heeren’s doctor is not actually Buttar himself, only trained by Buttar. Maybe he’s a good doctor.

Heeren’s doctor is Muneer ImamMuneer Imam a shy, kind looking man wouldn’t you agree?

Well, he may well be.

In Jan 1993, the New York Office of Professional Conduct charged Muneer Imam:

…with gross negligence, gross incompetence, negligence on more than one occasion and failure to maintain adequate records.

The Hearing Committee sustained the charges of negligence on more than one occasion, incompetence on more than one occasion and failure to maintain adequate records. The Hearing Committee found Imam guilty of careless practice, lack of attention to detail and failure to appreciate the severity of patient illness

The incidents have included at least one death of a patient under the care of Imam.

The Hearing Committee (incredibly in my view) said he could probably be rehabilitated and laid out a plan of rehabilitation.

This all took place under Imam’s work at an ER. Imam no longer does ER work. I asked a medical friend about why that might be and xyr response was:

Since he no longer seems to do ER work, I imagine he settled a med mal claim for deceased patient A, and his insurer refused to write coverage for ER work and no hospital would cover him

Is this really someone any parent would want to trust with the kids life? A doctor found to be incompetent, negligent and who doesn’t pay attention to detail?

This inability to pay attention to details certainly seems to be playing out on Heeren’s video. Here is Imam’s nurse (a Vietnam vet called Nick) fitting the IV for a course of chelation.

No sterile

When I showed this to my medical friend xyr response was horrified:

WTF is this alleged nurse doing starting an IV without gloves??? What happened to sterile technique? Have they lost their minds?

and

What is this alleged nurse doing using that frigging tiny gauge needle???

It seems that the chelation protocol Buttar uses specifies a 22 gauge butterfly needle, not the tiny one seen in the video. There are good reasons why:

…..because this is the easiest to use for employees with no medical training who call themselves “chelation technicians.” The tiny needle also serves to prevent patients from killing themselves by increasing the drip rate when they’re sick of sitting around for hours. Increasing the drip through a 22 gauge butterfly needle should (in theory) burst the vein before delivering Endrate at a lethal rate. Clever stuff.

While almost everyone can start an IV with this tiny needle, it’s dangerous to use for chelation because if patients get into trouble you want a large bore needle inserted in case you need to administer drugs and fluids for treatment or god forbid, resuscitation. Starting a second IV with an appropriate size needle in a patient in circulatory collapse from shock is difficult and sometimes impossible. The daunting prospect of starting an IV in the jugular makes sane physicians do everything to avoid being in this position.

Administering a bolus of calcium gluconate to counteract hypocalcemia through this tiny needle can result in a swollen hand (when the IV infiltrates) attached to a dead patient.

So – Nick the Nurse also has incompetence issues.

At one point in this video I thought I had gone mad. Did my ears deceive me or did I really hear Nick the Nurse describe how they also chelated with vinegar and garlic? I rewound the video. Yep, he said it alright. Vinegar and Garlic. I could say ‘wow’ or ‘holy crap’ to express my incredulity after hearing that but really, no words do it justice. They are chelating this poor lad with Garlic and vinegar.

And why? What for? First test

Here is Heeren’s son’s first ever lab report (click the image to get a bigger one).

Let’s remember that these lab reports are all part of the quack culture and I suspect are frequently exaggerated to get the parent to use more of their treatments. If even these results are exaggerated then I’m dumbfounded. Everything except Aluminium and Lead are within normal ranges. And even those two are just barely in the elevated range.

It is on this basis that Heeren decided to start chelating her son using a doctor described as medically negligent and incompetent under the tender care of a ‘nurse’ who doesn’t know the protocol he is supposed to be using and who is actively putting this boy (and presumably others) in potential danger.

Oh and don’t forget the garlic and vinegar. Thanks Rashid, thanks Muneer, thanks Nick.

99 Responses to “Autism, Chelation and Quackery”

  1. Another Voice April 16, 2007 at 04:00 #

    Breathing room outside of the circle???

    This is outside of the galaxy. These folks are using vinegar in a child’s vein. This is expensive witchcraft. They deserve no quarter!

    Did Mom or Dad try a bag of vinegar mixture, to see how it would feel? The DAN says it is safe, so give it a go.

  2. Ms. Clark April 16, 2007 at 04:24 #

    livsparents,

    Do you think that rubber gloves would protect the injector from a needle stick?

    Would you want someone to start an IV on you with ungloved hands? I wouldn’t.

    I don’t intend ever to accept medical fraud. The gullible have the right to hear the other side, the side the salesmen aren’t giving. I don’t see any “breathing room” when a child could die or be seriously harmed by a “therapy.”

  3. HN April 16, 2007 at 04:38 #

    Gloves are used to also protect the patient. Whenever you puncture the skin you are apt to introduce the flora (bacteria, fungi, etc) that live on YOUR skin into the puncture of the patient’s skin.

    That is also why the area to be punctured is swabbed with iodine (or in my case something else because I react to iodine) to clean the area being punctured. If you are going to be stuck by a needle (either at a doctor’s office, a tattoo parlor, blood bank, etc) and the person with the needle does not have gloves on… RUN AWAY!!!!

    I give blood on a regular basis. I am screened for infectious diseases before I have a needle stuck into me, and I am only ever touched by gloved hands.

    When is it ever proper to put a needle in a kid without gloves? Where is it shown that pushing drugs into a kid through an IV is an approved “cure” for autism? Who in their right mind puts that kind of child torture on the web for everyone to see? Why did it occur to that person that putting it on the web may not be a good idea only after this blog entry was posted?

  4. Bax Teria April 16, 2007 at 04:52 #

    See number one

    “If you are going to be stuck by a needle (either at a doctor’s office, a tattoo parlor, blood bank, etc) and the person with the needle does not have gloves on… RUN AWAY!”

    That’s good advice. Even the guys on Miami Ink (sorry Mr. Leitch – U.S. cable TV show about Tatoo business) seem to get it right.

  5. Phil April 16, 2007 at 07:21 #

    It would appear that Christine has removed the thread noted above completely and replaced it with a complaint about copyright.

    I was going to inform her that she was hurting her child on the new thread, but there is no option for anonymity. Some people have different ways of not listening.

  6. peelu April 16, 2007 at 07:48 #

    First Person : The food in this restaurant is so bad!
    Second Person: Yes! and such small quantities!

    🙂
    Peelu

  7. lordalfredhenry April 16, 2007 at 08:41 #

    A very expensive IV bag. Chelation is either ineffective or dangerous on children. It’s a treatment of last resort…and that’s for children who work in nuclear power plants during their handling of radioactive material. Sound crazy? So does the chelation if one thinks about it. Yes, nice exposé I think.

  8. Michael J. Dochniak April 16, 2007 at 12:13 #

    It appears that from many of the replies I’ve read this is a Brian Deer wanta-be site wherein everything is smoke and mirrors and perceived skeletons in the closet are editorial salvation.

  9. Lucas McCarty April 16, 2007 at 12:19 #

    As a picture thinker, do you have any idea how weird that sounds to me?

  10. Kev April 16, 2007 at 12:50 #

    Sorry we didn’t fall over ourselves agreeing with you Michael. I can only suggest you get yourself a blog where you can have everything to your own satisfaction.

  11. notmercury April 16, 2007 at 13:35 #

    Me too Lucas. I’m getting a rabid deer skeleton navigating around mirror stalagmites in a dark and smoke filled field.

  12. Eric April 16, 2007 at 15:51 #

    I feel saddened that a parent would have to resort to IV injections for chelation. There is plenty of research to indicate that heavy metals push children into autism (I don’t believe they are the ’cause’), so it follows that removing them may bring children back from over that edge. But injecting? No way, gentle DMSA is probably the best way. What kind of doctor does this?

  13. HN April 16, 2007 at 16:11 #

    Eric said: “There is plenty of research to indicate that heavy metals push children into autism”

    Could you point us to that research please?

    Though be aware that anything printed in “Medical Hypothesis” or “Medical Veritas” or even “JPANDS” would not be considered sources of research. Even though the first one is listed at http://www.pubmed.gov .

  14. qchan63 April 16, 2007 at 18:02 #

    I think the perfect topper to this video is when the poor kid is instructed to thank the nurse at the end, presumably for the extreme honor of being allowed to sit there for 2-plus hours while his veins are pumped full of what sounds more like salad dressing than medication.

    Yeah … thanks. Thanks a lot.

  15. Kev April 16, 2007 at 18:02 #

    Eric – David Quig’s work is not based in reality.

  16. Deer Kevin April 16, 2007 at 19:06 #

    “It appears that from many of the replies I’ve read this is a Brian Deer wanta-be site wherein everything is smoke and mirrors and perceived skeletons in the closet are editorial salvation.”

    Couldn’t agree more – both sites are pure bullshit.

  17. Kev April 16, 2007 at 20:23 #

    How hurtful ;o)

  18. qchan63 April 16, 2007 at 21:11 #

    Even the purest bullshit is nothing a little vinaigrette couldn’t chelate out, i feel sure.

  19. Michael J. Dochniak April 16, 2007 at 22:33 #

    Kev wrote:

    “Sorry we didn’t fall over ourselves agreeing with you Michael. I can only suggest you get yourself a blog where you can have everything to your own satisfaction”

    Comment:

    Thanks for the advice. Also to prometheus, the theory is in it’s infancy and your recommendation on testing was very good. Thanks

    I’d like to stick around, keep my mouth shut, and learn alittle more.

  20. notmercury April 16, 2007 at 22:35 #

    Gonna need a bigger bore needle for the shallots.

  21. livsparents April 17, 2007 at 01:26 #

    I was referring to the comments section, not the actual blog when I was talking ‘acceptance’; we are kind to those in agreement, but combattive with those who are not…

    I understand though, your sandbox, your rules…

  22. Ms. Clark April 17, 2007 at 02:34 #

    Bill started it! 😛

  23. Jeanette April 17, 2007 at 02:50 #

    The more I think about this Youtube video, the more I wonder what the mother was thinking.
    Okay, now she is mad because you found it and are commenting on it.
    If she did not want comments, why in the heck was it on Youtube???
    Was it to make herself feel better for the fact she was chelating her child, or to make other parent’s feel that it is okay to chelate their children?

    We are criticized daily for being lazy, non-caring, watching our children stimming, abusive, uneducated parent’s….

    I will take that any day over what I saw in that video or any others this mother has taped.

    I can put my precious little ones to bed every night and not feel badly about any procedures done to them.
    Call it whatever you want.

  24. melody April 17, 2007 at 03:38 #

    “Me too Lucas. I’m getting a rabid deer skeleton navigating around mirror stalagmites in a dark and smoke filled field.”

    notmercury, are you my 9-1/2 son? I swear you talk (type) like him. 😉 {and that’s not an insult, he’s brilliant}

    About this video, holy crap. It sounds like something from medieval times or perhaps a way to ward off vampires. And NO GLOVES…geez, just freak me out. It all just freaks me out.

  25. Anne April 17, 2007 at 04:41 #

    I doubt that the garlic and vinegar is given intravenously. I think you get the treatment from this guy. Google it yourself if you don’t believe me.

  26. Galloping Gourmed April 17, 2007 at 05:59 #

    But the nurse makes it sound like the boy was sitting there the whole time he was being treated. I don’t think the boy got his garlic and vinegar in an emema. Though maybe Buttar ordered it as an enema and nurse Nick got confused and gave it IV. My guess is that there’s nothing but sterile saline in the third bag and they tell the suckers that it has stuff that will mop up the aluminum and lead that the DMPS and glutathione misses.

    Can’t you just picture the menu and Nick asking, “What will it be this week Mrs. Zichitetta? The IV parsley looks good. Our customers have been raving about the effects of the imported IV chocolate, it’s very high in antioxidants you know, the children love it!.” They are selling beliefs. so why not sell a belief in intravenous garlic and vinegar. It’s all about selling up, so you try to get mom to agree to three bags instead of just one.

  27. Kev April 17, 2007 at 07:59 #

    Michael – you’re welcome to stick around, don’t feel you need to keep your mouth shut – speak up whenever you want, but – people disagree, its the way of the world.

  28. notmercury April 17, 2007 at 12:23 #

    Melody: “notmercury, are you my 9-1/2 son?”

    Aw, mom. You never let me have any fun 🙂
    Can I have some Cheese Nips?

  29. livsparents April 17, 2007 at 21:36 #

    “Bill started it! :-P”

    KEEEEVV, Ms Clark got sand in my shorts!

  30. Phil April 17, 2007 at 23:46 #

    Now, now, children – behave!

    (Typed while killing myself laughing!!)

  31. A lurker April 18, 2007 at 00:15 #

    Is that totally autistic?

    He makes eye contact. He responds to questions within an appropriate time frame. His fine motor skills look good. He has no apparent cognitive deficits. I see no stimming, perseverative behaviours or apparent signs of dysfunction of sensory integration.

    I don’t understand the term apparently.

  32. B lurker April 18, 2007 at 07:46 #

    He’s perseverating on writing “bus numbers” it’s how he’s passing much of his time in that chair. Perseveration on transit systems is absolutely classic autism. His mom believes he still autistic, hence her plan to keep chelating him.

    Nurse Nick says they give glutathione to autistic kids, looking at this boy while saying it.

    He says stuff that doesn’t fit in with what the others are saying, he’s not conversing with them, but just throwing non sequiturs out there.

    The “gains” his mom describes are typical of other spectrum kids would “gain” in the same time period, they aren’t startling or “proof” the chelation is creating his gains.

    He looks exactly like a PDD-nos kid. I would guess that his diagnosis is and was PDD-nos, though, we’d have to ask mom if he got an autistic disorder diagnosis in order to get services.

    A lurker, do you like the idea of this kid getting IV chelation?

  33. Michael J. Dochniak April 18, 2007 at 16:29 #

    Prometheus wrote:

    “In short, I will ‘complain’ that there is no data to support your assertions. In fact, there aren’t even any good anecdotes, if your article is an indication of the available information”

    Comment:

    The http://www.autismdoc.org article has good anecdotes in my opinion. For example, how IgE mediated reaction antibodies and associated mast cells affect the expression of neuron growth factor (NGF) and prenatal/neonatal development (i.e. allergy induced autism). What’s wrong with that Prometheus?

  34. Brian Deer April 18, 2007 at 17:42 #

    I see the autism omnibus claimants’ lawyers are unable to find a second and third test case.

    http://www.uscfc.uscourts.gov/OSM/Autism/4%209%2007%20PSC.pdf

    That figures. They only have something like six thousand allegations of vaccine injury to pick from. Finding three that could weather the light of day must be a real sweat.

    In the UK MMR action, they had 1,600, and couldn’t find four where the specific facts of the childrens’ cases stood up to five minutes’ scrutiny.

  35. A lurker April 18, 2007 at 18:17 #

    B lurker, I admit I could not hear everything because my very own auties were having a hootenanny in the neighboring room. They raise quite a ruckus given the right stimulus.

    Regarding the chelation: if there was clinical evidence of metal poisoning and substantial diagnostics that illustrated the metabolic consequences of such metal poisoning, then it *might* be something to consider.

    You gotta wonder though. If there were sufficient impairment of the detoxification systems such that metals accumulated in the first place then what is going to happen when the chelated forms are dumped enmasse into serum? And if “detox” is an issue how do you craft a treatment plan to avoid further accumulation?

    Not expert in this area, but I believe most of the chelators are nephro/hepatoxic in their own right.

    A cell is a pretty sensitive electromagnetic domain, what are the consequences of pulling out all those ions in such a non natural manner?

    Anyway, obviously the people conducting the procedure are quacks. If I caught someone starting a fucking drip on one of my kids without proper procedures I would go apeshit.

  36. B lurker April 18, 2007 at 20:21 #

    As far as I can tell, up until now in the United States, there is no evidence of even ONE autistic child being heavy metal poisoned. What we have are extremely misleading mail order lab reports that tell parents that their kids are heavy metal toxic when in fact the children are not. We can predict almost surely this boy’s urine is being tested by a mail order lab, probably Doctors Data.

    I think the word *hoax* fits very well here.

  37. C lurker April 18, 2007 at 21:10 #

    “What we have are extremely misleading mail order lab reports that tell parents that their kids are heavy metal toxic when in fact the children are not.”

    The labs are apparently pretty careful (if not thought complicit by some). The reports do not show kids as “heavy metal toxic”. They show kids as green, yellow, and red (within reference range, elevated, and very elevated), which is then immediately invalidated by disclaimer:

    “Reference ranges are representative of a healthy population under non-challenge or non­provoked conditions.”

    It doesn’t take a genius to figure out that if the test followed provocation, then the reference range used and “results” are worthless and don’t apply.

    It’s whoever is interpreting these worthless results and convincing people that they mean kids are “heavy metal toxic”, when the reports themselves make no such claim (or case for that matter), that are doing the misleading.

  38. A lurker April 18, 2007 at 21:26 #

    “As far as I can tell, up until now in the United States, there is no evidence of even ONE autistic child being heavy metal poisoned. What we have are extremely misleading mail order lab reports that tell parents that their kids are heavy metal toxic when in fact the children are not. We can predict almost surely this boy’s urine is being tested by a mail order lab, probably Doctors Data.

    I think the word hoax fits very well here.”

    Hold on a second, that seems quite an extreme generalization.

    I am not suggesting they all afflicted qualify as autistic, but lead poisoning is widespread, particularly in impoverished urban areas.

    I do believe I recall old research establishing atypically high (=>2sd) lead serum in autistics vs non-autistics.

    Heavy metal toxicity is a real medical condition, whether it is applicable to the apparent functional deficits of these children or not.

    If an infant or toddler were afflicted with heavy metal toxicity there would likely be profound developmental impairments.

    C Lurker, that is kind of obvious is it not? Is someone actually comparing metal excretion while undergoing chelation to the exrection profiles presented by the general population?

  39. A lurker April 18, 2007 at 21:32 #

    Actually a cursory search yields a thirty year old study stating that “psychotic” children were 2sd above mean of controls for serum lead. I think this is the one I recalled. There are other hits as well, but I am not sufficiently motivated to expend the energy in perusal.

  40. B lurker April 18, 2007 at 22:06 #

    A lurker said:
    “I am not suggesting they all afflicted qualify as autistic, but lead poisoning is widespread, particularly in impoverished urban areas.”

    Wrong. There is not a widespread problem with lead poisoning in inner cities today. I see you don’t want to support your statement with data now.

    The parents using these mail order labs are not even reporting high lead in most of their kids.

    Besides the word *hoax*, *scam* is also appropriate here. Here’s an easy representation of what we see in autism in the US.
    DAN!+ DDI labs = lucrative scam

    Federal level investigation into this fraud/hoax/scam would be very appropriate.

  41. A lurker April 18, 2007 at 22:29 #

    Lead is an issue anywhere there are old residential structures with peeling paint within which reside infants who place things in their mouthes.

    It is too starved an argument for my sword frankly. Google lead poisoning prevalence.

    The actual point:

    Heavy metal toxicity is a real medical phenomenon given sufficient exposure
    An infant or toddler with sufficient exposure to develop metal toxicity would almost certainly manifest significant developmental impairments
    Given the famously vague criteria of DSM such a child would likely qualify as autistic
    Stating that there is no evidence of metal toxicity as an underlying pathology in a patient presenting with autism is therefore dissembling at best.

    You jump from a reasonable, supportable statement to an unsupportable generalization which defies common sense; presumably to cater to your bias. Your apparent cognition is the inverse of that of the mercury milita.

    Who is making the fortune is this giant lucrative scam that you are promulgating (in a rather paranoid sounding manner I might add) DANs? DDI?.

    A federal investigation is needed? Why? Exactly who are you trying to protect with your evocation of the nanny state? Within the medical profession there are methods to deal with those whose conduct is malpractice. I don’t see anything else required.

  42. Kev April 20, 2007 at 08:03 #

    _”A federal investigation is needed? Why? Exactly who are you trying to protect with your evocation of the nanny state? Within the medical profession there are methods to deal with those whose conduct is malpractice. I don’t see anything else required.”_

    And outside the confines of the medical profession? Clearly a lot of the people practising the DAN! protocol – and all the other assorted quackery – are not medical doctors. I have heard of homeopaths practising chelation.

    Who regulates these people?

  43. Lucas McCarty April 20, 2007 at 15:34 #

    That’s their problem. They can’t make any moral arguement for mainstream medicine or ‘big pharma’ being brought to scrutiny without it equally applying to the quacks selling chelation as Autism treatment.

  44. Phil April 20, 2007 at 22:52 #

    Who regulates these people?

    In the US – I don’t think anyone does. That’s their idea of freedom.

    Pffft!

  45. Junior April 21, 2007 at 14:08 #

    Although I am no fan of IV chelation therapy for autism, I feel compelled to clear up some misconceptions expressed in Kevin’s blog and in the comments section about peripheral IV insertion. I have been a nurse since the mid 1980’s and have started countless IV’s.

    First of all, although gloves should be used for IV insertion as part of Universal Precautions relating to all body fluids, sterile gloves are not used. The insertion site itself (where the needle actually punctures the skin) should be as sterile as possible, and a sterile covering for the insertion site is recommended, however the procedure does not require sterile gloves or other components of sterile technique. Wearing gloves during these procedures protects the health care worker from potential pathogens in the patient’s blood. Hand washing before and after the procedures protects the patient from pathogens. Protection from pathogens is also provided by cleansing the insertion site with alcohol and/or Betadine.

    Medical facilities typically have Procedure Manuals outlining the protocol required for all medical procedures. I have located a couple of examples of these protocols for peripheral IV insertion online:

    http://www.sh.lsuhsc.edu/policies/policy_manuals_via_ms_word/Nursing/I-49.pdf
    5. Dons clean gloves*, selects appropriate site, applies tourniquet, and
    preps site with alcohol.
    NOTE: Do not palpate site after skin has been cleansed with antiseptic.
    (*clean gloves are not sterile)

    http://www.guideline.gov/summary/summary.aspx?doc_id=8338&nbr=4666
    d. Wash hands: Good hand hygiene and standard precautions are used for insertion and IV maintenance; a new pair of disposable nonsterile gloves may be used in conjunction with a “no-touch” technique for peripheral IV insertion. With “no-touch” technique, the planned IV insertion site is not palpated after skin cleansing, unless sterile gloves are worn. Wash hands before and after IV catheter insertion and dressing change (O’Grady et al., 2002).

    Obviously the nurse in the video is not wearing gloves at all which is actually not that surprising to me considering he is an older nurse. When I first learned how to start IV’s and draw blood we did not wear gloves. The recommendation to wear gloves during these kinds of procedures came with the advent of AIDS and Universal Precautions (now called Standard Precautions) in1985. Reference: http://www.corexcel.com/html/body.infection.control.page2.ceus.htm

    Many nurses, myself included, who learned how to access veins before the advent of Universal Precautions found it difficult to adjust to using gloves. This is because the “feel” of a vein, the bounciness and size is very important in deciding whether or not it would hold a needle or IV catheter. Also, many times veins are not visible, but on ly felt under the skin. Feeling a vein with a bare finger, vs. feeling it through a glove is very different. I did adjust to wearing gloves, although generally I would feel for a vein with a bare finger and then don gloves and clean the insertion site.

    If you watch the video, you will see the nurse swab the index finger, middle finger, and thumb of his right hand before he inserts the angiocath (IV catheter). This technique offers the nurse no protection if there is leakage of blood from the catheter or insertion site, but it may offer as much protection to the patient from potential pathogens as clean gloves do. Consider that unsterile gloves are typically kept at the patient’s bedside in an open container, and no recommendations are given for using an antiseptic on the gloves before venous access procedures.

    I also want to address the size of the venous access device. Although my eye sight is not as good as it used to be, it did not appear to me that the IV catheter used was a butterfly as I didn’t see any “wings” on it. IV catheters are color coded according to size, and these colors are standardized across brands. It looked to me like the IV catheter that was used in the video was pink which would make it a 20 gauge. Reference: http://www.umecopr.com/pages/medical_surgical/iv_catheters.html

    Lastly, I just don’t even know what to say about the garlic and vinegar, surely they didn’t mean they are giving that IV! That’s craziness!

  46. Junior April 21, 2007 at 14:11 #

    I also need to add that the nurse in the video should have worn gloves, at least for his own protection.

  47. Ms. Clark April 21, 2007 at 19:47 #

    Junior, The person who told Kev about the dangers of tiny-needles (and no gloves) said: “While almost everyone can start an IV with this tiny needle, it’s dangerous to use for chelation because if patients get into trouble you want a large bore needle inserted in case you need to administer drugs and fluids for treatment or god forbid, resuscitation.”

    In your opinion would a 20 guage needle be “large bore” enough to administer drugs and fluids for treatment in an emergency?

    If the child is being chelated because misleading lab tests told the mom that the child is “heavy metal toxic” then it’s still patently wrong what they are doing. The doctor (not a pediatrician, not a toxicologist) is smart enough to know that the child doesn’t need to be chelated based on a mail order lab test result, but he’s making money off of chelation so he chelates kids, with the help of Nurse Nick, it would appear. If he gets hurt in any way by this, even if his veins are getting damaged from the weekly chelation (making it harder for Nick to get a vein each time)… it’s abuse. Telling the kid that he’s got all these bad metals in him when it’s not true is abuse, in my opinion. It’s all about making mom feel like she’s a hero and doing all she can do undo the damage done by the evil CDC et al. And the mom was promoting chelation by putting this video out there, encouraging others to do IV chelation in the process.

    I still think they are claiming they put the vinegar and garlic in him with the IV fluid. To get rid of imaginary lead and aluminum.

  48. Kassiane April 22, 2007 at 04:42 #

    And…erm…not everyone can start a butterfly (or a 20 gague, one size up) on anyone.

    I am 24. I am of reasonable height and weight-that is, larger than most children being subjected to this horrendous procedure.

    AND. I have yet to find someone who can start an IV on me first shot. There’s been lots of opportunities to try, between dehydration (diabetes insipidus…when you’re sick even 2 gallons won’t do), migraine treatment, seizure precaution…the “best of the best” in one epilepsy center took three tries.

    Anyone can do it, huh?

    Does this kid have bigger veins than I do somehow? Or is it more likely that mom is playing fast and loose with his safety while praying at the alter of Normal?

  49. Junior April 22, 2007 at 15:39 #

    I do think a 20 gauge would be okay in the case of a potential emergency. 20 gauge IV’s are what we typically started on the average adult patient that was in the hospital. 18 gauge’s were started on patients that needed blood or who were going to surgery, but as Kassiane points out, sometimes you start the size IV that the patient’s veins will support. For a child a 20 gauge is actually a large IV, and a 22 gauge would be commonly used as well.

    Consider this passage from a Nursing 2000 journal article titled: “Tips and tricks for pediatric I.V. insertion” http://findarticles.com/p/articles/mi_qa3689/is_200012/ai_n8915169

    “What size device should I use?
    Choose the smallest-gauge catheter (24 or 22) in the shortest length to allow hemodilution of infusates by blood flow around the catheter. In neonates, administer I.V. fluids and medications, blood, and blood products via a 24-gauge I.V. device. In older children, a 24- or 22-gauge catheter works without increasing the risk of hemolysis. “

    Although, I don’t have a problem with how the IV was started or the size of the IV, there are lots of things I do have a problem with in this video from a nursing perspective.

    1. All pediatric medicines and IV fluids should be on IV pumps. This protects the child from accidental fluid overload and more precisely regulates how the infusion rate of medications. If the IV is not on an infusion pump then microdrip IV tubing and/or a soluset (aka a solutrol or volutrol) is used. These also protect the child from fluid overload and allow for more precise calculation of drip rate. Children will typically receive a slower IV rate than adults and less volume for the obvious reason that they are much smaller. http://www.accd.edu/sac/nursing/math/peds2.html
    Neither a pump, nor a microdrip, nor a soluset, were used in this situation.

    2. I have concerns about the amount of fluid given over this 2 hour and 10-15 minute period. It is hard for me to tell the exact sizes of the IV bags used from the video. There are 3 bags given, 2 of them look to be in the 50-100 cc range. I assume the 2 smaller bags are the glutathione and the “garlic and vinegar”. The third bag is much larger and the solution is yellow so I assume it is the DMPS. At the time in the video that this bag is shown, it looks to me like there is about 300 cc of fluid in that bag. Although, I must say I may be completely off since it is hard to tell from a video. I assume that the child received all this fluid since at the end of the video there are 3 IV lines and it is obvious that the IV bags are empty. My estimate then, and I want to repeat that I may be way off here, is that this child received 400 cc (possibly more since I’m not sure at what point in the infusion the yellow IV bag was shown) of IV fluid in 2 hours, which seems like a lot to me. To be honest, I’m not sure if it would be a problem or not in a healthy child.

    3. It also concerns me that none of the IV bags appear to have labels on them that say what medications have been added, although it’s possible they are labeled on the back and I just can’t see it in the video. If there aren’t any labels this scares me for a couple of reasons. First, it means that these bags were mixed in the clinic, because no pharmacist would mix an IV bag without putting a label on it. I just wonder what kind of standards are used for mixing these bags. Secondly, all nurses have a fear of making a medication error and take all precautions possible to prevent errors. It is taught in nursing school, and it is on licensing exams, that all medications are labeled. I assume that this child is not the only patient in the clinic receiving medications, and I also assume that there are also adult patients there after looking at this doctor’s website: http://hamptonsmedicalspa.com/default.aspx I further assume that all patients don’t require the same dose of the medications this child was given. Thus it concerns me that errors might be made by giving a patient the wrong medication when bags are not labeled. Again, it is very possible the bags were labeled and I just couldn’t see it.

    4. I looked for some infusion protocols for IV DMPS but was unable to find any. I have no idea what the potential complications might be for this type of infusion. I did find a protocol for giving CaEDTA which I thought was interesting if you compare it to the procedure that was described in the case where the child died when he received IV push EDTA. http://www.mainehealth.org/workfiles/mmc_bush/Leadguideline3.pdf I especially found it interesting that this treatment guideline says to give the medication over 24 hours, and that there should be continuous cardiac monitoring during the infusion.

    5. This leads me to my final concern. I assume this clinic, and perhaps most IV chelation clinics are stand alone clinics not connected to a hospital. I would be concerned about the emergency equipment they have in the clinic, the number of personnel they have who are trained to deal with emergency situations, and the transit time to a hospital if that was required. There should be a crash cart in the clinic with a cardiac monitor and defibrillator, as well as emergency medications, and emergency equipment such as endotracheal tubes, and oxygen. Staff should be trained in PALS, including the physician. I would wonder if a doctor who has been trained in adult medicine has ever been involved in a pediatric resuscitation effort, much less directed such an effort.

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