title: Study of placing a second intravenous line in trauma.
abstract: OBJECTIVE
  We evaluated the benefit of emergency medical services providers' placing a second intravenous (IV) line in the prehospital trauma setting. Our hypothesis was that the placement of a second IV catheter in trauma does not result in an improvement in heart rate, blood pressure, rehospitalizaton rate, or 30-day mortality.
  
  
  METHODS
  A retrospective chart review of 320 trauma patients in a one-year period was conducted at our level I trauma center. All trauma patients who had vascular access obtained prehospitally were included.
  
  
  RESULTS
  Patients with two IV lines received an average of 348.4 mL more fluid (95% confidence interval [CI]: 235.6, 461.1; p < 0.0001). No change in heart rate, pulse oximetry, Glasgow Coma Scale score, systolic blood pressure, rehospitalization rate, or 30-day mortality was noted. These effects persisted for patients who were initially tachycardic (heart rate 3.92 bpm; 95% CI ?3.01, 10.82; p = 0.27) or hypotensive (blood pressure 22.00 mmHg; 95% CI ?4.17, 48.16; p = 0.10).
  
  
  CONCLUSIONS
  Redundant prehospital IV lines provided no noticeable benefit in physiologic support for trauma patients. When controlling for confounding variables, no significant outcome difference was noted, even in the hypotensive patients. The traditional approach for establishment of a secondary IV line in prehospital trauma patients should not be followed in a dogmatic fashion.
authors.affiliation: Department of Emergency Medicine, Robert Wood Johnson Medical School, New Brunswick, New Jersey 08901, USA. merlinma@umdnj.edu
authors.forename: Mark A
authors.initials: MA
authors.lastname: Merlin
authors.forename: Emily
authors.initials: E
authors.lastname: Kaplan
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Schlogl
authors.forename: Heather
authors.initials: H
authors.lastname: Suss
authors.forename: Frank D
authors.initials: FD
authors.lastname: DosSantos
authors.forename: Pamela
authors.initials: P
authors.lastname: Ohman-Strickland
authors.forename: Adam
authors.initials: A
authors.lastname: Shiroff
mesh_terms: D000328:Adult; D001794:Blood Pressure; D016001:Confidence Intervals; D003971:Diastole; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D004634:Emergency Medical Technicians; D005260:Female; D015600:Glasgow Coma Scale; D006305:Health Status Indicators; D006339:Heart Rate; D006801:Humans; D007262:Infusions, Intravenous / Q000295:instrumentation / Q000379:methods*; D015601:Injury Severity Score; D008297:Male; D009515:New Jersey; D010092:Oximetry; D012189:Retrospective Studies; D013599:Systole; D014193:Trauma Centers; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000401:mortality