By Ryan MacArthur |

It can be difficult enough to insert and monitor a patient’s IV in the hospital, but doing so in the back of a moving ambulance comes with an additional set of challenges.

Learn more about the obstacles of IV therapy in ambulances, including IV placement and IV failure.

IV Insertion

When it comes to IV placement in ambulances, EMS professionals have a relatively high success rate.

The American Journal of Emergency Medicine found that emergency medical technicians and paramedics successfully started at least one IV in 80% of medical patients and 92% of trauma patients.

A two-person paramedic crew was found to have higher rates of overall success placing IVs than a one-person crew, but not necessarily higher rates of success on their first attempt.

IV Failure in Ambulances

While there are several different causes of IV failure, accidental IV dislodgement is often at the top of EMS personnel’s list of frustrations.

Driving over potholes, turning sharp corners, and weaving in and out of traffic are a few factors that may cause IVs to be removed unintentionally during transport.

EMS providers are trained to recognize symptoms of IV failure and IVs delivered in a non-hospital environment are subject to the same complications – possible infiltration, air embolisms, hematomas, phlebitis, and compartment syndrome. The Journal of Trauma Nursing found no statistically significant difference in phlebitis or infection rates with IV therapy in ambulances versus in-hospital IVs.

How EMS Can Help Prevent IV Failure

There are steps EMS providers are trained to take in order to avoid these possible complications with IV therapy in ambulances.

  • Make sure that the catheter is firmly secured
  • Secure the patient during transport to help minimize possible dislodgement
  • Keep an eye on the catheter and the IV site during and after insertion

If you find yourself in an ambulance, conscious and needing an IV, do your best to communicate to the EMS personnel if you are a “hard stick.” One tip is to inform them where previous medical providers have had success finding veins – this can save valuable time and avoid painful pricks in an unsuccessful search for a usable vein.

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References:

Image Source: https://nypost.com/2015/10/04/it-takes-more-than-14-minutes-to-get-an-ambulance-in-the-bronx/ 

Success rates for initiation of intravenous therapy en route by prehospital caregivers –

https://www.ncbi.nlm.nih.gov/pubmed/2363751  

Ambulance Crew Configuration: Are Two Paramedics Better Than One? –

https://www.jems.com/articles/2018/10/ambulance-crew-configuration-are-two-paramedics-better-than-one.html  

When EMS Should Start An IV –

https://www.ems1.com/iv/articles/2031599-When-EMS-should-start-an-IV/  

Legal Lesson of the Month: The Dislodged IV Needle –

https://www.emsworld.com/article/220800/legal-lesson-month-dislodged-iv-needle

 

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