Intravenous Fluids in EMS

Inter-Canyon Fire Rescue EMTs, EMT-Intermediates and Paramedics all can initiate intravenous (IV) therapy for a number of different reasons.  Some of the most common reasons:

1.  Replenish lost fluids due to blood loss, diarhea, vomiting, and evaporative loss (sweating due to heat).
2.  The administration of medications.
3.  Cooling of the patent following successful resuscitation from cardiac arrest.

The use of intravenous (IV) therapy in administering IV fluids and medications is a routine intervention performed frequently in the out-of-hospital setting.   Common IV sites include the inside of the elbow, forearm, and the external jugular (the large vein on the side of the neck).  Typically blood is withdrawn at the time the IV is started.  These tubes of blood can then be delivered to the hospital with the patient for analysis.

The use of large volumes of IV fluids in trauma (significant blood loss) is controversial.  The Denver Metro Paramedic Protocols which guide pre-hospital care limit the volume of IV fluids to prevent complications. 

A common reason for initiating IV therapy is to use the IV as a route for medication administration.

Finally cold IV fluids may be used in patients following sucessful resuscitation after cardiac arrest.

ICFR ambulances carry IV fluid warmers (to prevent cooling of a patient receiving IV fluids) and IV fluid coolers (to chill the fluids for administration after cardiac arrest).