Abstract
Attempting vascular access by out-of-hospital medical providers is one of the most common and important interventions performed. Hypovolemia, hypothermia, obesity, previous intravenous drug administration or abuse, burns, and amputations complicate the establishment of venous access. Failure rates have ranged between 10% and 40% 1 Lewis FR Prehospital intravenous therapy. J Trauma. 1986; 26: 804-811 Crossref PubMed Scopus (114) Google Scholar and have taken upward and beyond 25 minutes to establish. 2 Macnab A Christensen J Findlay J Horwood B Johnson D Jones L et al. A new system of sternal intraosseous infusion in adults. Prehospital Emerg Care. 2000; 4: 173-177 Crossref PubMed Scopus (82) Google Scholar Such delays deprive a patient of intravenous fluids, volume replacement, and medications and delay arrival at definitive care. Delay in intravenous access and preceding interventions are associated with higher morbidity and mortality rates. 3 Jones SE Nesper TP Alcouloumre E Prehospital intravenous line placement. Ann Emerg Med. 1989; 18: 244-246 Abstract Full Text PDF PubMed Scopus (76) Google Scholar Establishing vascular access in 90 seconds, although widely considered an operational goal of out-of-hospital providers, is rarely achieved.
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