Abstract
Objective
To overcome the lack of larger, population-based studies reporting the prevalence
of insertion of PIVCs and IO devices, and to describe the patient-related and service-related
characteristics of these devices, inserted by paramedics, in an Australian state ambulance
service.
Methods
A retrospective analysis of the electronic Ambulance Report Form (medical record)
and Computer Aided Dispatch system from the 1st July 2016 until 30th June 2017.
Results
709,217 events were analysed. Of these, 20.4% involved at least one successful PIVC
insertion and 0.07% involved at least one successful IO device insertion; most of
the time on first attempt (89% and 86.4% respectively). Most PIVCs were inserted into
the right antecubital fossa or dorsum of the right hand while IO devices were inserted
into the proximal tibia. Of male patients, 21.4% received PIVCs while 19.5% of female
patients received PIVCs. Very low numbers of both male and female patients received
IOs (0.1%). Medical, non-traumatic presentations were the most common presentation
and received the most insertions of both devices, followed by trauma presentations.
Advanced Care Paramedics inserted 84.0% of PIVCs while Critical Care Paramedics inserted
94.4% of IO devices. Time treating and transporting patients generally increased with
number of attempts at vascular access undertaken.
Conclusions
Queensland paramedic practices relating to insertion of PIVCs, and IO devices appears
consistent with documented practice internationally. Further study is required to
determine whether the antecubital fossa and dorsum of the hand insertions are clinically
necessary in this population as areas of flexion and distal extremities are generally
to be avoided for PIVC insertion.
Keywords
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Article info
Publication history
Published online: March 08, 2022
Accepted:
March 1,
2022
Received in revised form:
February 24,
2022
Received:
November 30,
2021
Identification
Copyright
© 2022 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.
