title: Utilisation of prehospital intravenous access.
abstract: OBJECTIVE
  To describe the use of intravenous (IV) therapy in the South African (SA) prehopsital setting, and to determine the proportion of prehopsital cannulations considered unnecessary when graded against the South African Triage Score (SATS) chart.
  
  
  METHODS
  The study was conducted in the prehospital emergency medical care setting in the Western Cape Province, SA. Using a descriptive research design, we looked at the report forms of patients treated and transported by personnel currently employed in the public sector, serving the urban and rural areas stipulated by the municipal boundaries. All medical and trauma cases in which establishment of IV access was documented for the month of April 2013 were included. Interhospital transfers, unsuccessful attempts at IV access and intraosseous cannulation were excluded.
  
  
  RESULTS
  When graded against the SATS, prophylactic IV access was not justified in 42.3% of the total number of cases (N=149) in which it was established, and therefore added no direct benefit to the continuum of patient care. It is worth noting that 18.8% (n=39) of the IV lines were utilised for fluid administration, as opposed to 9.2% (n=19) for the administration of IV medications.
  
  
  CONCLUSIONS
  In view of the paucity of studies indicating a direct benefit of out-of-hospital IV intervention, the practice of precautionary, protocol-driven prophylactic establishment of IV access should be evaluated. Current data suggest that in the absence of scientific evidence, IV access should only be initiated when it will benefit the patient immediately, and precautionary IV access, especially in non-injured patients, should be re-evaluated.
authors.affiliation: Department of Emergency Medical Sciences, Faculty of Health and Wellness Sciences, Cape Peninsula University of Technology, Cape Town, South Africa. sobuwas@cput.ac.za.
authors.forename: B H
authors.initials: BH
authors.lastname: Bester
authors.forename: Simpiwe
authors.initials: S
authors.lastname: Sobuwa
mesh_terms: D061605:Administration, Intravenous; D002404:Catheterization / Q000706:statistics & numerical data*; D004632:Emergency Medical Services / Q000379:methods*; D005440:Fluid Therapy / Q000706:statistics & numerical data*; D006801:Humans; D012189:Retrospective Studies; D013019:South Africa; D013997:Time Factors; D014218:Triage; D019564:Unnecessary Procedures / Q000706:statistics & numerical data*