History of IV therapy in EMS

[thrutheashes]

Hey guys,

I am doing an IV therapy review module for my service, and just for kicks was wanting to throw in a slide on the history of IV therapy. I've been able to get some info so far, however, the answer to one question still eludes me. Does anyone know what year IV therapy came to the pre-hospital setting? If anyone knows or can point me in the right direction I would definitely appreciate it.

Thrutheashes

[island emt]

I can remember IV's being done regularly when I started in 1971.

Not as common as today as the skill was limited to the few Paramedics and nurses that worked in the streets back then.

Flash forward to 2012, + I'd wager 60=70 % of all pt's receive IV therapy or at a minimum a saline lock for medication access.

[chbare]

It's probably not possible to give you a concrete answer. The concept and rudimentary practice of IV therapy dates back at least as far as the European renaissance. The practice was refined and began to proliferate during the early to mid 1900's leading to our current practice.

[Kiwiology]

In NZ pre hospital IV therapy has been around in the hands of the Advanced Care Officer (Paramedic) since the 1972 Life Support Unit (Mobile Intensive Care) pilot project was established in Auckland. It became main stream for Intermediate Care Officers in the mid 1980s where it remains to this day, although Intermediate Care Officer no longer exists but it is a mid level skill.

[celticcare]

With the use of IV therapy now adays here, every IV has to be justified, inserting an IV in the field whilst the patient has good veins because you know they will need bloods and medications when they reach hospital does not qauntify as a justifiable excuse for inserting a Leur and so less are being inserted in the metropolitan areas. Or because of short transport times, Leurs are often not inserted because of the load and go process.

I have medic textbooks dating back to the Early 70's showing IV insertion Techniques, so has been around in EMS for a while, just the exact date as a whole is difficult to ascertain, though Johnny and Roy inserted them

Scotty

[croaker260]

I have old texts and references pointing to Combat medics doing IVs in the field during WWII. Dont know if that helps.

[thrutheashes]

Hey Croaker, that does help. Could you give me the name, author, and year published of your reference?

[Bullets]

Depending on how you view the history of EMS, combat medics were administering reconstituted human plasma and whole blood units in the field during WWII

This is the website for the US Army's Office of Medical History, and has a section on both WBU and Plasma administration in a combat setting

http://history.amedd.army.mil/booksdocs/wwii/blood/DEFAULT.htm

[Bieber]

With the use of IV therapy now adays here, every IV has to be justified, inserting an IV in the field whilst the patient has good veins because you know they will need bloods and medications when they reach hospital does not qauntify as a justifiable excuse for inserting a Leur and so less are being inserted in the metropolitan areas. Or because of short transport times, Leurs are often not inserted because of the load and go process.

Not to derail the topic, but I'm not quite understanding how it is not justifiable to initiate IV access when it is anticipated that it will be used to draw blood or push meds in the hospital? Also, maybe what metropolitan areas are you referring to? I work in a fair sized urban city and I would find it appalling to withhold appropriate treatment because the transport time is short.

Thanks.

[Eydawn]

Not every patient transported by EMS to the ER will need IV therapy. Starting an IV prehospitally is not always appropriate IMHO. Starting an IV just because you can, or because you think you should, is not a great idea.

I started several superfluous IV's on patients who really didn't need them. Pissed me off. It's not withholding treatment if they don't need it in the first place... with the risks associated with IV insertion and IV therapy are not small...

The instances in in which it's acceptable to insert one prehospitally, IMHO, are chest pain patients, possible stroke, respiratory, and fever (possible sepsis). Stubbed toe? Busted arm? Unless you need to deliver IV pain meds, it could wait...

Wendy

CO EMT-B