PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of jrsocmedLink to Publisher's site
 
J R Soc Med. 1995 April; 88(4): 213P–216P.
PMCID: PMC1295168

Prehospital intravenous fluid replacement in trauma: an outmoded concept?

Abstract

Details of 235 consecutive trauma patients brought to the Washington Hospital Trauma Center with intravenous infusions in situ were entered into the study. The volume of intravenous fluid administered prior to arrival at hospital and the time over which it was given (the infusion time) was recorded. The initial systolic blood pressure (SBP) on scene and the SBP on arrival at hospital were documented. A mean volume of 383 ml of intravenous fluid was administered over a mean time of 17 min. Of non-trapped patients 98% had infusion times of less than 30 min. Trapped or hypotensive patients were not given significantly more fluid than those who were not trapped or had SBPs of over 100 mm Hg. Because of the uncertain benefits and potential complications of this procedure, intravenous cannulation and fluid replacement may not be appropriate where expected prehospital time is likely to be less than 30 min.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (625K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Bickell WH, Shaftan GW, Mattox KL. Intravenous fluid administration and uncontrolled hemorrhage. J Trauma. 1989 Mar;29(3):409–409. [PubMed]
  • Lloyd S. MAST and i.v. infusion: do they help in prehospital trauma management? Ann Emerg Med. 1987 May;16(5):565–567. [PubMed]
  • Lawrence DW, Lauro AJ. Complications from i.v. therapy: results from field-started and emergency department-started i.v.'s compared. Ann Emerg Med. 1988 Apr;17(4):314–317. [PubMed]
  • Gold CR. Prehospital advanced life support vs "scoop and run" in trauma management. Ann Emerg Med. 1987 Jul;16(7):797–801. [PubMed]
  • Jacobs LM, Sinclair A, Beiser A, D'Agostino RB. Prehospital advanced life support: benefits in trauma. J Trauma. 1984 Jan;24(1):8–13. [PubMed]
  • Potter D, Goldstein G, Fung SC, Selig M. A controlled trial of prehospital advanced life support in trauma. Ann Emerg Med. 1988 Jun;17(6):582–588. [PubMed]
  • Cales RH. Advanced life support in prehospital trauma care: an intervention in search of an indication? Ann Emerg Med. 1988 Jun;17(6):651–653. [PubMed]
  • de la Roche MR. Is prehospital advanced life support really necessary? CMAJ. 1987 Dec 1;137(11):995–999. [PMC free article] [PubMed]
  • Pons PT, Moore EE, Cusick JM, Brunko M, Antuna B, Owens L. Prehospital venous access in an urban paramedic system--a prospective on-scene analysis. J Trauma. 1988 Oct;28(10):1460–1463. [PubMed]
  • Kaweski SM, Sise MJ, Virgilio RW. The effect of prehospital fluids on survival in trauma patients. J Trauma. 1990 Oct;30(10):1215–1219. [PubMed]
  • Wangensteen SL, Eddy DM, Ludewig RM. The hydrodynamics of arterial hemorrhage. Surgery. 1968 Nov;64(5):912–921. [PubMed]
  • Lewis FR., Jr Prehospital intravenous fluid therapy: physiologic computer modelling. J Trauma. 1986 Sep;26(9):804–811. [PubMed]
  • Hedges JR, Feero S, Moore B, Shultz B, Haver DW. Factors contributing to paramedic onscene time during evaluation and management of blunt trauma. Am J Emerg Med. 1988 Sep;6(5):443–448. [PubMed]
  • Spaite DW, Tse DJ, Valenzuela TD, Criss EA, Meislin HW, Mahoney M, Ross J. The impact of injury severity and prehospital procedures on scene time in victims of major trauma. Ann Emerg Med. 1991 Dec;20(12):1299–1305. [PubMed]
  • Donovan PJ, Cline DM, Whitley TW, Foster C, Outlaw M. Prehospital care by EMTs and EMT-Is in a rural setting: prolongation of scene times by ALS procedures. Ann Emerg Med. 1989 May;18(5):495–500. [PubMed]
  • Cwinn AA, Pons PT, Moore EE, Marx JA, Honigman B, Dinerman N. Prehospital advanced trauma life support for critical blunt trauma victims. Ann Emerg Med. 1987 Apr;16(4):399–403. [PubMed]
  • Jones SE, Nesper TP, Alcouloumre E. Prehospital intravenous line placement: a prospective study. Ann Emerg Med. 1989 Mar;18(3):244–246. [PubMed]
  • O'Gorman M, Trabulsy P, Pilcher DB. Zero-time prehospital i.v. J Trauma. 1989 Jan;29(1):84–86. [PubMed]
  • Slovis CM, Herr EW, Londorf D, Little TD, Alexander BR, Guthmann RJ. Success rates for initiation of intravenous therapy en route by prehospital care providers. Am J Emerg Med. 1990 Jul;8(4):305–307. [PubMed]

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press