Prehospital IV's

AKav8trix · Jun 17, 2005

Is there a standard for restarting IV's that have been started by EMS? At your facility do you have a policy regarding "field" IV's?

Most of the facilities in my area pull field starts after 24 hours with the belief that they aren't sterile. It's unfortunate though, because all the field IV's I've ever started or witnessed started are just as sterile (or even more) than hospital starts I've seen. IMHO a lot of good PIV's are pulled unecessarily.

The one exception is in a bad trauma when everything is so messy you just do the best you can to make the area as clean as possible to get fluids going stat, because you may never get it totally sterile.

pricklypear · Jun 17, 2005

To my knowledge, we don't have a specific policy on field IVs. If they're good, we leave them for 3 days. Sometimes we have to move the big 18g in the little old lady's RAC so she can eat, though. I think our EMS might have some policy on only starting lg bore AC sites in everybody! LOL.

suzanne4, RN · Jun 17, 2005

Please do a search on this site. There is a fairly recent thread on this same topic. With many, many responses. :)

AKav8trix · Jun 17, 2005

To my knowledge, we don't have a specific policy on field IVs. If they're good, we leave them for 3 days. Sometimes we have to move the big 18g in the little old lady's RAC so she can eat, though. I think our EMS might have some policy on only starting lg bore AC sites in everybody! LOL.

Hehe, yep, I'll have to admit its true that we do tend to go for the AC's with the big caths. There's no official policy that I know of but it certainly does typify field starts. :chuckle

Now that I've got the hospital's perspective on things as a graduate nurse, when I'm on the ambulance I try to start someplace other than the AC when it's needed only as a "just in case" but not life or death necessary, and I feel that the forearm or hand veins are good enough that they won't blow while bouncing down the road as I'm trying to start it. Also, we don't have a way to warm the arms and hands to get the smaller veins to pop up like we do in the hospital, so sometimes AC's are the best we can find with the resources we have.

RNKPCE · Jun 17, 2005

Within 24 hours of admission. We get many overnight patients so this policy spares them a stick. However there are a lot of nurses that just ignore that it is a paramedic IV and leave it in. It is pretty obvious when it is a paramedic IV as they use a different extension tubing than we use.

pricklypear · Jun 17, 2005

I'm not an IV therapy nurse ( although I worshipped the ground they walked on when I worked with them!) but I just don't see the point of removing a perfectly good IV and reinserting another. Unless, as RNlove2fly mentioned, it was a trauma and messy. EMS uses the same aseptic techniques we do in the hospital. As long as it's clean, patent what's the big deal? Our EMS doesn't use extension tubing, but that is easily fixed by converting over to our extensions. They do use the same caths - which allows us to do that. I would hate having to explain to some patient that has been poked 2-3 times for lab, etc..I have to restart this just because you got it in the ambulance. Another hole, another chance for infection. I'm glad we don't have to do that.