IV therapy pre-hospital

  1. I am a paramedic coordinator and former IV nurse. Recently a nurse educator contacted me stating that she had noticed an increased infection rate in pre-hospital IV starts. This came as no suprise to me. I thought it was common practce to d/c pre-hospital IV's during the 1st 24 hours. Does anyone know of any studies to support this?
    Thanks, Dana RN
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  2. 4 Comments

  3. by   Terrie Hogan
    Just found this site.....At our facility we allow pre-hospital IV starts to remain in place per our 72 hour protocol, as long as no problems occur. We do, however, pull and restart all trauma IV starts. The rationale being that "scoop and run" cases do not allow for the best site prep and placement. As for infections in pre-hospital starts, we have seen a few, most being due to mecanical phlebitis from sites near joints such as the wrist or AC. I personally restart these, providing the pt has adeq veins.
  4. by   emsKyle
    I'm an Advanced Care Paramedic in Canada and just found this site and it's pretty cool - lots of good info. However, I was bit surprised reading about prehospital IV's commonly being DC and having increased risk of complications. We do a fair amount of clinical time in OR's, ER's as well as in numerous other areas of various hospitals and I am confident saying my aseptic technique in the 'on-the-street' is just good as most nurses in hospital. Granted the conditions that we do IV's in are not always ideal but the risk of infection is high on our list of priorities and so every possible precaution is taken. Alcohol swabs are used until the site is clean, opsites are used as a sterile dressing, etc. Also, the rationale for restarting "scoop-and-run" IV's is understandable but still not necessarily agreed with. I have seen complacency as well as aseptic techniques relaxed in and out of the hospital equally.
    My two cents.
  5. by   rundontwine1
    Quote from emsKyle
    I'm an Advanced Care Paramedic in Canada and just found this site and it's pretty cool - lots of good info. However, I was bit surprised reading about prehospital IV's commonly being DC and having increased risk of complications. We do a fair amount of clinical time in OR's, ER's as well as in numerous other areas of various hospitals and I am confident saying my aseptic technique in the 'on-the-street' is just good as most nurses in hospital. Granted the conditions that we do IV's in are not always ideal but the risk of infection is high on our list of priorities and so every possible precaution is taken. Alcohol swabs are used until the site is clean, opsites are used as a sterile dressing, etc. Also, the rationale for restarting "scoop-and-run" IV's is understandable but still not necessarily agreed with. I have seen complacency as well as aseptic techniques relaxed in and out of the hospital equally.
    My two cents.
    I am currently a paramedic and an MSc student. Regarding the pre-hospital infection risks, I am planning to look at the aseptic techniques favoured by paramedics. I am hoping to identify, 'and to avoid shutting the door after the horse has bolted' areas, such as: storage and use of latex-free gloves. This will hopefully lead onto how the catheter hub may contribute to the colonisation of catheters. It would be extremely helpful if you could send me your protocols for IV cannulation, so I can make comparisons. If anyone reading this knows of any research papers in this field, could they get in touch, as there seems to be a distinct lack of supporting evidence
  6. by   rundontwine1
    I am currently a paramedic and an MSc student. Regarding the pre-hospital infection risks, I am planning to look at the aseptic techniques favoured by paramedics. I am hoping to identify, 'and to avoid shutting the door after the horse has bolted' areas, such as: storage and use of latex-free gloves. This will hopefully lead onto how the catheter hub may contribute to the colonisation of catheters. It would be extremely helpful if you could send me your protocols for IV cannulation, so I can make comparisons. If anyone reading this knows of any research papers in this field, could they get in touch, as there seems to be a distinct lack of supporting evidence

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