The success rate of intravenous line set-up increased in EMTs with expansion of their opportunities

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  • NAKAMURA Hideaki
    Graduate School of Health Science, Major of Paramedic, Teikyo Heisei University
  • NAKAZAWA Mayumi
    Department of Emergency Medical Science, Faculty of Medical Science, Nippon Sport Science University
  • INOUE Takayasu
    Environmental Science Center, Tokyo University
  • TANAKA Kotaro
    Department of Emergency and Critical Care Medicine, Ibaraki Seinan Medical Center Hospital
  • KARIMA Risuke
    Graduate School of Health Science, Major of Paramedic, Teikyo Heisei University Department of Medical Science, Faculty of Health Medical, Teikyo Heisei University
  • SUZUKI Hiromasa
    Graduate School of Health Science, Major of Paramedic, Teikyo Heisei University Department of Medical Science, Faculty of Health Medical, Teikyo Heisei University BANDO-Medical Control

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  • 処置拡大前後における救急救命士の静脈路確保成功率に関する検討
  • ショチ カクダイ ゼンゴ ニ オケル キュウキュウ キュウメイシ ノ ジョウミャクロ カクホ セイコウリツ ニ カンスル ケントウ

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<p>INTRODUCTION: Two new conditions for intravenous approach (IVA) were approved in emergency medical technicians (EMTs) by revision of licensing act in 2014. Before revision of this act in Japan, IVA was permitted to EMTs only at emergency occasion such as cardiopulmonary arrest (CPA). The new conditions for IVA comprise of glucose infusion for hypoglycemia and fluid infusion for hypotension both requiring immediate resuscitation and available only by well-trained EMTs on IVA techniques. These new conditions are expected to create more chances for EMTs to improve their skills in IVA and result in increasing success rate of IVA at out-of-hospital setting METHOD: Emergency rescue records (Utstein style data) collected from Ibaraki Seinan Fire Department, Ibaraki prefecture, Japan, from 2014 to 2016 were retrospectively analyzed by chi-square test to identify change in the success rate of IVA infusion before and after revision of the act. Data of 2014 and 2016 were compared due to the reason that emergency rescue program revised to comply with the new act started to function from 2016 in this region. RESULT: After revision in the program, chances for EMTs to set up IVA increased by 34%. Along with it, overall success rate of IVA significantly increased from 52.2% in 2014 to 63.2% in 2016, (p<0.01). Even for CPA cases, the success rate of IVA increased from 52.2% to 63.8% (p<0.01). Infusion success rate after revision was highest (78.5%) in hypoglycemic cases and lowest in CPA cases (58.5%). CONCLUSION: Expanding conditions for EMTs on IVA set-up created more chances for these people to operate in actual setting, which resulted not only in the increased IVA success in new conditions but also in more difficult and extreme CPA conditions.</p>

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