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32.0 IV/IO Access
All Providers
- Universal Patient Assessment Protocol
- Indications for IV Access
- Patient requires IV fluids and/or medications
- Patient may become unstable enroute or at the Emergency Department
- Patient may require blood laboratory urgently
Key Considerations
- Review provider orders for IV solution, additives, and rate
- Parameters for discontinuing IV
- Apply cardiac monitor to all patients receiving IV fluids
- Inspect IV site every 10 minutes for infiltration, bleeding, or erythema
- DC IV if signs or symptoms of fluid overload: rales/hypoxia
Adult
EMT
- Monitor Only: Crystalloid fluid only, NO additives
AEMT
- IO Access Indications
- Severe illness or injury requiring immediate fluid or drug administration IO may be considered prior to peripheral IV attempts
Paramedic
- IO Lidocaine prior to administration of fluids/medications in the conscious/alert patient
- DC IV containing POTASSIUM if signs/symptoms of hyperkalemia:
- ventricular fibrillation
- peaked T waves on ECG
Pediatric
not to exceed adult dose
EMT
- Monitor Only: Crystalloid fluid only, NO additives
AEMT
- IO Access Indications
- Severe illness or injury requiring immediate fluid or drug administration IO may be considered prior to peripheral IV attempts
Paramedic
- IO Lidocaine prior to administration of fluids/medications in the conscious/alert patient
- DC IV containing POTASSIUM if signs/symptoms of hyperkalemia:
- ventricular fibrillation
- peaked T waves on ECG