Intravenous Coffee

We coffee drinkers have all wished for that morning dose of caffeine to be directly injected to get that first shot pulsing through our veins as quickly as possible. Sometimes we’ve even had whole days like that.

While we know this to be a joke, IV caffeine has actually been used in treating stimulant drug abusers. From the Journal of Pharmacology and Experimental Therapeutics April 1995:

Intravenous caffeine in stimulant drug abusers: subjective reports and physiological effects. C R Rush, J T Sullivan and R R Griffiths

AbstractThe present study was conducted to examine the self-reported (i.e., subjective) and physiological effects of intravenous caffeine in 10 subjects with histories of stimulant drug abuse. Under double-blind conditions, subjects received each dose of caffeine (0, 37.5, 75, 150 or 300 mg/70 kg) twice according to a latin-square design; injections were 10 sec in duration and separated by at least 24 hr. Effects were measured before injection and repeatedly afterward for 60 min. Caffeine dose-dependently increased ratings of positive mood (e.g., increased ratings of drug liking and high), which peaked at 2 min after injection and progressively decreased. Caffeine also dose-dependently increased the frequency of stimulant identifications on the Pharmacological Class Identification Questionnaire (e.g., like cocaine, amphetamine). Caffeine also produced negative-mood effects (e.g., increased ratings of bad effects) and increases in self-reported desire for cocaine. In contrast to the positive-mood effects, the negative-mood effects were of smaller magnitude and only significant at the highest dose. Caffeine increased reports of unusual smells and tastes. Caffeine decreased heart rate (7 bpm) and skin temperature (4 degrees C), and increased systolic and diastolic blood pressures (8 and 6 mm Hg, respectively). The mood effects but not the physiological effects of intravenous caffeine were similar to those previously observed with cocaine in studies using similar methods and subjects. Intravenous caffeine administration may provide a useful model system for investigating factors relevant to the use and abuse of stimulant drugs.

However, in careless hands, IV coffee can have serious negative effects: i.e. death.

Rejane Moreira Telles said that she had just three days of work experience in a Rio de Janeiro clinic when she botched up administering a drip to Palmerina Pires Ribeiro, who died hours after she had coffee mixed with milk injected straight into her body.

The 23-year-old appeared on Brazilian TV Globo’s Fantastico where she told reporters that she was aware of the risk of administering an intravenous feed. However, the novice nurse added that “anyone can get confused.”

“As they [the feed and blood drips] were next to each other, anyone can get confused. I injected the coffee and I put it in the wrong place,” Telles told the TV station.

Telles, who has been indicted for involuntary manslaughter alongside two nurses and another student, claimed that she was not trained to perform that kind of procedure.

The question that comes up, but is not answered in the article is—how much supervision she was under at the time? If she acted entirely on her own, she was undoubtedly in the wrong. However, if she was asked to hook up the IV and wasn’t observed, then, either her supervisors were negligent, or the system that allowed a novice to be in such a situation is  broken. Too often, in situations such as this, we see the truth of the adage “shit rolls down hill”. The investigation here should have been top-down, ensuring procedures were in place to minimize the chances of something like this happening.

In the end, the most unfortunate part was Ms. Ribeiro’s passing.

doctors said that the milky coffee would have gone directly to the elderly woman’s heart and lungs.

“It would have been as if the patient was suffocating,” Dr. Armando Carreir,a  nutritional specialist at the Federal University of Fluminens’ Hospital Antonio Pedro, told reporters at TV Globo’s Fantastico.

The victim’s daughter, Loreni Ribeiro told the station that she witnessed the trainee nurse give her mother the coffee injection.

“I saw my mother was agitated, she opened her mouth, and this youngster put coffee with milk into the veins of my mother. Half a glass,” Ribeiro said.

Perhaps the correct people are being punished, perhaps not. We’ll probably never know.

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