Interesting observational study of 56,332 patients picked up in an EMS system in King County, looking at IV access and outcomes.
For reasons they don’t look into in this study, they find that IV access is an independent predictor of decreased in-hospital mortality. Not for the less-acute patients, but for patients of high-acuity, lack of IV access shows a pretty significant trend towards poor outcomes. They don’t look at fluid therapy, medication therapy, etc. as confounding variables – so we don’t know what it is specifically about IV access that confers a survival advantage.
They do a brief breakdown of the systolic blood pressure and the percentage of patients receiving IV access, and, as expected, more IVs are attempted at the extremes. This leads me to believe there are patients who were high acuity, required IV access, but had failed IV access attempts – but there’s no data on that either.
This is a study that could end up telling us something, or nothing. Interesting, nonetheless.
“Intravenous Access During Out-of-Hospital Emergency Care of Noninjured Patients: A Population-Based Outcome Study”
http://www.ncbi.nlm.nih.gov/pubmed/21872970