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Unnecessary intravenous access in the emergency setting
R A Henderson1, D P Thomson, B A Bahrs
1EastCare Transport Program, University Health Systems of Eastern Carolina, Greenville, North Carolina 27835-6028, USA. hendersonra@ecu.campus.mci.net
Prehospital Emergency Care
|November 3, 1998
Summary
Many emergency department intravenous (IV) lines are placed unnecessarily. Pre-hospital IV access without immediate treatment does not speed up emergency care, highlighting the need for cost-benefit analysis.
Area of Science:
- Emergency Medicine
- Health Services Research
Background:
- Intravenous (IV) access is a common procedure in emergency settings.
- The necessity and utilization of IV access in emergency departments (EDs) warrant investigation.
Purpose of the Study:
- To determine the rate of unnecessary intravenous (IV) access in the emergency setting.
- To evaluate the impact of pre-hospital IV access on time to treatment.
Main Methods:
- Retrospective chart review of 940 patients in a rural, academic emergency department.
- Analysis of IV placement by Emergency Medical Services (EMS) and in the ED.
- Comparison of IV utilization and time to treatment.
Main Results:
- 349 patients received IV access, but only 154 (44.0%) received treatment through the IV.
- 38% of pre-hospital IVs and 46% of ED-initiated IVs were used.
- Pre-hospital IV access did not reduce the time to treatment in the ED.
Conclusions:
- A significant percentage of IVs initiated in the emergency setting are used inappropriately.
- IV access without immediate treatment in the field does not improve elapsed time to treatment.
- Further study on the cost-benefit ratio of emergent IV access is recommended.