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Study of Placing a Second Intravenous Line in Trauma.
MedLine Citation:
PMID:  21294630     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Abstract Objective. We evaluated the benefit of emergency medical services providers? placing a second intravenous (IV) line in the prehospital trauma setting. Our hypothesis was that the placement of a second IV catheter in trauma does not result in an improvement in heart rate, blood pressure, rehospitalizaton rate, or 30-day mortality. Methods. A retrospective chart review of 320 trauma patients in a one-year period was conducted at our level I trauma center. All trauma patients who had vascular access obtained prehospitally were included. Results. Patients with two IV lines received an average of 348.4 mL more fluid (95% confidence interval [CI]: 235.6, 461.1; p < 0.0001). No change in heart rate, pulse oximetry, Glasgow Coma Scale score, systolic blood pressure, rehospitalization rate, or 30-day mortality was noted. These effects persisted for patients who were initially tachycardic (heart rate 3.92 bpm; 95% CI ?3.01, 10.82; p = 0.27) or hypotensive (blood pressure 22.00 mmHg; 95% CI ?4.17, 48.16; p = 0.10). Conclusions. Redundant prehospital IV lines provided no noticeable benefit in physiologic support for trauma patients. When controlling for confounding variables, no significant outcome difference was noted, even in the hypotensive patients. The traditional approach for establishment of a secondary IV line in prehospital trauma patients should not be followed in a dogmatic fashion.
Authors:
Mark A Merlin; Emily Kaplan; Jeffrey Schlogl; Heather Suss; Frank D Dossantos; Pamela Ohman-Strickland; Adam Shiroff
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-4
Journal Detail:
Title:  Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors     Volume:  -     ISSN:  1545-0066     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9703530     Medline TA:  Prehosp Emerg Care     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
From the Department of Emergency Medicine (MAM), Robert Wood Johnson Medical School, New Brunswick, New Jersey; and the Departments of Medical Education (EK, JS, HS, FDDosS), Public Health (PO-S), and Surgery (AS), University of Medicine and Dentistry of New Jersey?Robert Wood Johnson Medical School, New Brunswick, New Jersey.
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