Interesting. Totally off topic, but I know of people with dysautonomia (POTS specifically) who get home care saline infusions. I believe they already have a port. Not sure if it has the same risks or not as an IV with regard to anaphylaxis and other issues you mentioned.
Edit:
I don't need IV fluids personally, but I've seen this video pop up before in dysautonomia communities (at the end of it the "patient" says her husband is becoming trained to administer IV fluids at home):
~~~~~OFF TOPIC SKIP IF YOU WANT~~~~~~
Ports are used specifically because they are different from PIVs (I didn't specify I meant peripheral IVs before) and the risks associated with them are different, but the decision to use a port over an IV is one of necessity since they pose greater risks longterm overall. The reality is that for repeated infusions and/or for certain medications, a little wimpy peripheral vein is not going to cut it and a port is more practical.
The material in an implanted port is more "sturdy", "hypoallergenic", and is specially coated to decrease the main risks of leaving a plastic tube in someone: clotting & bacterial growth, vs PIV tubing, which is cheaper & meant for much shorter term use (I believe most hospitals will change PIV tubing every 3 days, I could be wrong on the exact number. It's less than 10 days for sure.)
I don't know much about home care infusions in all honesty, except that I know they have special training to not only reduce infection risk in administration, but to recognize signs of complication from the port or the infusion. I wouldn't be surprised if they also carried an epi pen (I know the most common dangerous adverse infusion reaction overall is anaphylaxis, although the most common overall is allergic, not all allergic reactions are equally dangerous) but there I am only speculating.
Even the medical decision to use an epi pen for "rescue" has a whole host of factors to consider.
Look at IVDU if you want to see the harm that "simple" stabbing yourself with a needle, into or not into a vein, can do. And that's not just cuz they're using dirty needles, injecting dirty stuff, or not using sterile technique. Risk still isn't zero even when it's done in the hospital.
I don't know much about standard of care regarding patients doing self administered PIVs.
I don't think they're a good idea, even in health care professionals that know how to do them "properly."
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I know this was off topic, I just wanted to address some reasons I can think of for why certain home interventions that are seemingly "harmless" that patients with a surface understanding may think "why can't I MacGuyver this at home, I watch them do it in the ED 1000x it hardly looks like rocket science," actually require a deeper understanding of how things work, risk vs benefit, possible negative outcomes (even if rare), and how to respond in those scenarios.
In our training, and related a little to what I said above about people seeing medical stuff happen and then getting the sense they could do it themselves, we are all told the stories of scientists that did some of their own science on themselves to advance the field.
Ethically, besides the issue of possible self-harm, is the question of a loss of objectivity.
As we discussed, yes, psychiatry is a field where, more than a lot of fields of medicine, the outcomes we are trying to effect, are for the most part, subjective. You need some subjectivity in your psychiatrist. You also need some objectivity.
If you have a suicidal, homicidal, psychotic patient, the "fear of the off switch" from a personal experience with Seroquel swaying your prescribing hand could be a total disservice depending on the whole picture. In a perfect world you would not factor that into your prescription, but cognitive biases are sure to remain.
All doctors are expected to appreciate side effects and the patient's subjective report, however, that doesn't mean we must *experience* the same. Experience clouds all our judgment to some extent.
Getting into projection and transference/countertransference, I would argue that while there is GREAT value in using the ways your experience overlaps with a patient's in order to help them (my example is my prior personal experience with cigarette smoking cessation), that is also when as a physician you need to be the most CAUTIOUS in maintaining objectivity. It can harm as much as it helps.
I would rather psychiatrists did not take the medications they prescribed, so that they would be more guided by objective studies, and clinical experience in observing harm/benefit in patients with specific conditions. Those I believe will act as more unbiased and appropriate guides. (exception being when a psychiatrist has to take a psych med as Rx'd by their tx'ing provider)
I could paint you a picture for how this could happen with, say, anxiety and benzos. Or Adderall and ADHD.
I won't say that I have taken psych meds for/not for psych conditions, except to say that I really believe the experience of the sufferer vs not sufferer for so many of these drugs is distinct enough that truly, no reason to bother. I see greater risk of the development of negative biases in prescribing needed meds than an increase in sympathy for side effects, etc etc
