Arterial Lines

[nina]

HI

I´m medical student in austria and also a sort of Paramedic.

I've a question about arterial lines in EMS

Are u allowed to inserte an arterial line as a paramedic in case of emergency?


Thanks for help!

Greets Nina

[AZCEP43]

Not on purpose. More importantly there is not really a good reason to place one since most places don't have the equipment to maintain the site, or monitor the pressure from it.

It has been known to happen when an IV attempt goes bad though.

[VentMedic]

Arterial Line Insertion is not part of a Paramedic's training in the U.S.

They are allowed to monitor them on some Critical Care Transport Teams with additional training.

The exceptions to the rule are Flight Teams. However, this is done more for BP monitoring during an inter-facility transport. The A-line will usually be inserted before leaving the hospital and not in the field.

Specialty teams such as Cardiac, Pediatric and Neonatal Transport insert peripheral arterial lines as well as UVCs and UACs. However, these teams usually consist of Nurses and Respiratory Therapists, who are allowed to perform these procedures.

[nina]

Thanks a lot for your replies! It`s interesting to know how different the systems are!!

In Austria we have an other system than in the U.S.! We do have a kind of "emergency doctor" who supports our EMS! Things u can easiliy do in U.S. e.g. IV lines is not allowed to all of us in austria

In my local EMS it is common to inserte arterial lines when neccessary in the field, in fact the "doctor" does.

So its not easy to compare these two systems!!!

Nice day Nina

[VentMedic]

They insert arterial lines but not IVs? For what purpose do they put the arterial lines in your prehospital situations?

Inserting an arterial line can be a very painful procedure with the potential for loss of circulation to the hand as well as damage to the radial nerve. In the U.S., we generally like to do it under aseptic or sterile technique when possible with the patient and person doing the arterial procedure in good position.

[nina]

No don't missunderstand me!

The common way the doctors do is to inserte an IV line. But when neccessary in special situation (patient with cardiorespiratory problems) they also inserte an arterial line for IBP monitoring or blood gas analysis.

I only wanted to explain that the "in the field" procedures are different!!
As u said before it is not common to do arterial lines in US but it is done by the emergency doctor in austria.

Its also different what paramedic are allowed to do in U.S. or Austria. So u are allowed to inserte IV lines, but the most of us in Austria are not!

Do u understand me now a bit better??

Nina

(Maybe my English is not the best)

[AZCEP43]

I think you may be comparing two vastly different skill sets, or levels of care.

A physician is not commonly used prehospital in the U.S. There is too much liability, and not enough reimbursement for this level of care to make it worth doing.

[nina]

yeah thats what i was triying to say!

we have emergency physicians! So i understand that the ways of treatment are different!! Especially the procedures in emergency care..

[RicanMedic78]

nina,

u have doctors in a pre hospital care setting?

[FIREMEDIC23]

The ciriculum doesn't include inserting a-lines for paramedics.