We attempted to determine the effect of a statewide pediatric training program on prehospital intravenous (IV) placement for children less than 8 years of age that was conducted for all paramedics in the state for 1992-93. Training included a skills station for scalp and extremity IV, and intraosseous line placement. It emphasized that when transport time to a hospital was short, "load and go" was preferred to placing an IV before transport.
Emergency medical services (EMS) and related hospital ED and inpatient records were obtained and matched by probabilistic data linkage. We succeeded in matching 80% of EMS runs to hospital records. Our analysis was restricted to those children brought from a scene to a hospital and excluded inter-facility transfers. Injury severity scores (ISS) were calculated using ICDMAP-90 software.
The proportion of children less than age 8 who had prehospital IV placement did not change following training. When an IV was placed, mean EMS scene times fell from 25 minutes prior to training to 19 minutes afterwards; this was not seen in older children and adults. IV placement was reduced from 11% to 5% (p<.05) when transport times were less than 6 minutes. For children less than 8 years old whose principal diagnosis was trauma, there was an increase in mean ISS score in those who had prehospital IV placement following the training program. This study suggests that the training was effective but is limited by the lack of knowledge of how many IV attempts were made.
Learning Objectives: To analyze and measure changes in prehospital pediatric IV placement by paramedics following a vascular access training program
Keywords: Professional Training, EMS/Trauma
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.