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Related Experiment Videos

Zero-time prehospital i.v.

M O'Gorman1, P Trabulsy, D B Pilcher

  • 1Department of Surgery, University of Vermont College of Medicine, Burlington.

The Journal of Trauma
|January 1, 1989
PubMed
Summary
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Initiating intravenous (IV) access en route to the hospital is highly successful for trauma patients. This approach avoids transport delays and improves resuscitation efforts, making prehospital IVs a valuable intervention.

Area of Science:

  • Emergency Medicine
  • Trauma Care
  • Prehospital Care

Background:

  • Prehospital stabilization and resuscitation significantly impact trauma patient outcomes.
  • Controversies exist regarding Advanced Trauma Life Support (ATLS) protocols, particularly concerning prehospital intravenous (IV) access.
  • Concerns about transport delays and inadequate fluid resuscitation from prehospital IVs have been raised.

Purpose of the Study:

  • To evaluate the success rates of prehospital IV access attempts initiated at the scene versus en route to the hospital.
  • To determine if initiating IV access en route can overcome arguments against prehospital IVs due to transport delays.

Main Methods:

  • Prospective study of 350 consecutive trauma patients from October 1985 to November 1986.
  • Documented IV access attempts, success rates, and patient blood pressure.

Related Experiment Videos

  • Compared on-scene IV attempts with en route IV attempts.

    • Main Results:

    • Overall IV access success rates were 77% on-scene and 81% en route.
    • For patients with blood pressure < 100 mm Hg, en route IV success was 72% compared to 66% on-scene.
    • IV access attempts en route demonstrated high success rates, even in hypotensive patients.

    Conclusions:

    • Initiating IV access en route to the hospital is a successful strategy for trauma patients.
    • This approach minimizes or eliminates transport delays associated with prehospital IV insertion.
    • Protocols should prioritize en route IV access for non-trapped patients to optimize resuscitation and avoid delays.