Prehospital Venous Access in an Urban Paramedic System-A Prospective On-scene Analysis
| Autor: | Lewis Owens, Barbara Antuna, Peter T. Pons, Ernest E. Moore, James M. Cusick, Michael Brunko |
|---|---|
| Rok vydání: | 1988 |
| Předmět: |
Emergency Medical Services
medicine.medical_specialty Resuscitation Colorado Critical Care and Intensive Care Medicine System a law.invention law Task Performance and Analysis medicine Humans Prospective Studies Infusions Intravenous Prospective cohort study Vein Stopwatch Scene analysis business.industry Surgery Catheter medicine.anatomical_structure Time and Motion Studies Emergency medicine Wounds and Injuries business Blood sampling |
| Zdroj: | The Journal of Trauma: Injury, Infection, and Critical Care. 28:1460-1463 |
| ISSN: | 0022-5282 |
| DOI: | 10.1097/00005373-198810000-00009 |
| Popis: | Prehospital intravenous access has been central to the debate of paramedic intervention during management of trauma in the field. Some have suggested that excessive time requirements for IV access are detrimental to patient salvage. This prospective study objectively quantified the time required to place a peripheral IV line in our urban paramedic system. A third-party observer, nonparamedic, timed the procedure on scene with a stopwatch. Total intravenous time, including obtaining a 30-cc blood sample, was defined as the period from removal of the catheter cover until the catheter was taped. The study group included 125 patients (51 trauma and 74 nontrauma). The average total time to obtain IV access and sample blood was 2.20 +/- 0.20 and 2.71 +/- 0.18 minutes in trauma and nontrauma patients, respectively. In a subset of 63 patients in whom blood sampling time was determined separately, subtracting that from total IV time provided a net of 0.58 +/- 0.09 minutes to obtain access. Fourteen patients had a second IV line started (without blood sampling), requiring 1.25 +/- 0.38 and 0.70 +/- 0.24 minutes, respectively, for trauma and nontrauma patients. Paramedics were successful on their first IV attempt in 90% of trauma and 84% of nontrauma patients; ultimate success was 100%. This on scene study documents the time required for prehospital IV access, performed by a well-trained paramedic in an E.M.S. system with strong medical control, is less than 90 seconds. |
| Databáze: | OpenAIRE |
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