Maintenance of IVs by EMTs
|Bureau of EMS Policy Statement|
|Policy Statement #||04-02|
|Subject||Maintenance of IVs by EMTs|
MAINTENANCE OF IVs BY EMERGENCY MEDICAL TECHINICIANS - BASICS
This policy is intended to clarify that an Emergency Medical Technician—Basic (EMT-B) may not transport a patient with an intravenous line (IV) in place. The Department of Health, Bureau of Emergency Medical Services (BEMS) at the request of the State Emergency Medical Advisory Council (SEMAC) was asked to clarify the role of an EMT-B in providing care to patients who require IV therapy.
This issue has been addressed previously by the Department of Health and the SEMAC. A former opinion provided by the Bureau of Emergency Medical Services (EMS) in September 1991, indicated that a non-medicated IV could be maintained and discontinued by a basic EMT if special training were provided to the EMT, and the training was documented by the ambulance service. This opinion is now rescinded in part due to the changing composition of pre-hospital care providers. In the mid-1980s, there were a minimal number of advanced EMS providers who were able to respond to the demands of facilities requiring the transportation of patients requiring IV maintenance. Currently, there are significantly more ALS providers who can appropriately care for patients that require advanced EMS care and IV therapy.
The SEMAC has determined that it is no longer permissible for a BLS ambulance service, staffed by EMT-Bs to transport a patient with an IV line in place.
This applies to the following situations:
- Intravenous lines with fluid.
- Intravenous lines with medication.
- Central and peripheral vascular access devices with medication.
It is allowable for an EMT-B to transport a patient with a secured saline lock device in place as long as no fluids or medication are attached to the port. However, the EMT-B must insure that the venous access site is secured and dressed prior to leaving the health care facility.
Hospitals and long term care facilities are responsible under state and federal regulations to assure a patient is transported with the appropriate level of medical care necessary to the patient’s medical condition. The transport of a patient with an IV, medicated or non-medicated, requires the presence of an advanced emergency medical technician or a licensed health care provider with the appropriate skills. A basic level ambulance may transport a patient with an IV only if the hospital or nursing home provides appropriate medical staff to accompany the patient to maintain the IV. If the hospital or nursing home cannot provide medical staff during the transport of the patient, then an advanced life support ambulance service must provide the service. In order for an EMT-B to care for the patient, the IV must be discontinued or secured with a non-medicated saline lock device during transport
Edward G. Wronski, Bureau Director
In conjunction with the SEMAC