Abstract
Objective
To investigate the prevalence of intravenous and interosseous device insertion in
the prehospital setting by prehospital clinicians, and the characteristics of patients
receiving these devices as reported to the United States of America National Emergency
Medical Services Information System.
Methods
A retrospective analysis of the United States of America National Emergency Medical
Services Information System public release dataset for the 2016 calendar year.
Results
A total of 20,454,975 events involving 40,438,959 procedures were analysed. One or
more peripheral intravenous catheters were inserted during 27.4 % of events, and one
or more intraosseous devices in 0.4 % of events. Insertion was completed with one
attempt in 71.6 % of peripheral intravenous catheter insertions and 86.9 % of intraosseous
devices insertions. Insertion was successful for 74.7 % of peripheral intravenous
catheter insertions and 85.4 % of intraosseous device insertions. High rates of peripheral
intravenous catheter insertion were found with: being female (51.6 %), aged 40–90
years (80.2 %), having a cardiac rhythm disturbance (70.3 %), having a primary symptom
of change in responsiveness (58.7 %), or when there was initiation of chest compressions
(50.4 %). There were high rates of intraosseous device insertion if the patient was
male (57.8 %), aged 40–90 years (77.2 %), experienced a cardiac arrest (29.2 %), had
chest compressions initiated (33.6 %), or died (16.4 %). Scene time was longest for
events with intraosseous devices inserted (19.7 min, IQR 13.2–28.6) but transport
time shortest (9.0 min, IQR 5.0–15.0).
Conclusions
The distribution of patient factors and the insertion of peripheral intravenous catheters
and intraosseous devices is described at a national level for the first time. The
results provide prehospital clinicians and Emergency Medical Services rigorous data
to compare, and possibly improve, practice.
Keywords
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Article info
Publication history
Published online: June 07, 2022
Accepted:
May 31,
2022
Received in revised form:
May 31,
2022
Received:
October 25,
2021
Identification
Copyright
© 2022 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.
