Vascular access attempts should not unnecessarily delay transport: attempts should be completed en route. All attempts are to be documented on the PCR.
Indications for Peripheral Vascular Access:
This procedure may be performed on any patient whenever there is a potential need for: A. Intravenous drug administration B. Need to administer IV fluids for volume expansion
Key procedural considerations:
A. Saline locks may be used when appropriate and flushed with a 3 cc bolus of NS as needed. B. Extension tubing should be used on all IV lines.
Indications for Intraosseous Access (Paramedic for Adult and Peds, AEMT for Adult Only):
This procedure may be performed on any patient who requires IV drugs or IV fluids AND who is: A. Unconscious and unresponsive; and B. Peripheral line cannot be immediately established.
Contraindications: Placement in, or distal to a fractured bone
Key procedural considerations: Only 1 (one) attempt is permitted per extremity
Indications for use of Previously Established Central Line Access:
This procedure may be performed on any critically ill or injured patient who requires IV drugs or IV fluids AND in whom a peripheral line cannot be established.
Contraindications: Inability to freely aspirate blood out of the catheter.
Key procedural considerations: Central line access (Implantable Ports, Port-A-Caths, Medports)
A. May only be used if the device has already been accessed and IV fluid set-up has been established and running. B. These devices require special needles (non-coring type) for access. The device may be damaged if standard jumper (conventional) needles are used to access the ports.