Saline Locks Instead of IV's on Patients

[1EMT-P]

Do any of you use Saline Locks instead of IVs on trauma patients?

[EmergencyMedicalTigger]

:? No, never seen that done for a trauma pt.

[medic001918]

With more theories coming out that support permissive hypotension, I have placed saline locks in trauma patients. But, this is usually only a secondary point of access after they have a bag of fluid already in place. If the receiving hospital will not accept labs from the field, having a well placed lock can help the hospital to pull labs quickly. It has seemed to have worked well for me so far and the hospital usually appreciates it.

Shane

NREMT-P

[Ridryder 911]

I will use a saline locke for the secondary or third I.V., or a after the fluid bolus. I usually have one infusing, one at a keep open rate with a blood set on it so PRBC's can be immediately placed.

Be safe,

R/r 911

[chbare]

I believe over aggressive fluid management causes more harm than good, (hemodilution, blowing out clots, messing up clotting factors) This is especially true in the patient who has internal noncompressible bleeding. However, it is nice to have an IV started with blood tubing so PRBC's can be rapidly infused if needed. A saline lock is nice for a secondary or third IV site.

Take care,

chbare.

[ncmedic309]

But, this is usually only a secondary point of access after they have a bag of fluid already in place. If the receiving hospital will not accept labs from the field, having a well placed lock can help the hospital to pull labs quickly. It has seemed to have worked well for me so far and the hospital usually appreciates it.

I do the same thing. I will usually use a 16 ga. cath for the fluids and put an 18 ga. cath in w/ PRN adaptor just to have in place if needed and for the hospital to pull blood for labs.

[Rezq304]

I use a saline lock on all patients. Depending on the situation and need for fluids, I will attach a bag of fluids to the lock as necessary. I've just found it easier to not accidentally yank out the IV that way. Also, our primary receiving facility will accept labs drawn by EMS, so 90% of my patients that would get labs in the hospital will get labs drawn in the ambulance. Just makes it easier on my facility and keeps the nurses happy.

[1EMT-P]

I don't usually use saline locks on trauma patients, I usually use 16 or 18 ga of NS running at KVO.

[firemedic78]

:? may be a stupid question, but why don't most of yall get blood on the box? cost maybe? [-X Do the hospitals not want you to get blood for them? Here we (all local services) get blood on just about everyone that gets an IV. They almost strangle us if we don't have blood and have an IV...depending on the severity of the call of course! On patients not requiring fluids, we place a lock...otherwise just TKO'em.

[Mdog]

We have been using canula and cap for years with administration of drugs only requiring saline flushes. I have never experienced any problems with this and don't understand why so many of your services are still insistant on fluid volume simply to administer a drug.