ALS IV Directive Flashcards
What are the indications for the Intravenous and Fluid Therapy Medical Directive
Actual or potential need for intravenous medication OR fluid therapy.
What are the conditions for IV Cannulation?
Age ≥2 years
What is the contraindication for IV cannulation?
Suspected fracture proximal to the access site.
What are the indications for 0.9% NaCl Fluid Bolus?
Age ≥2 years.
SBP Hypotension
What is the contraindication for 0.9% NaCl fluid bolus?
Fluid overload.
What is TKVO for ≥2 years to <12 years?
15 ml/hr.
What is TKVO for ≥12 years?
30-60 ml/hr
What is the mandatory provincial patch point for the ALS IV directive?
Patch to BHP for authorization to administer 0.9% NaCl fluid bolus to hypotensive patients ≥2 years to <12 years with suspected Diabetic Ketoacidosis (DKA).
What is the dose for ≥2 years to <12 years IV 0.9% NaCl fluid bolus?
20 ml/kg, reassess every 100 ml. Max. volume 2000 ml.
What is the 0.9% NaCl fluid bolus for patients ≥12 years?
20 ml/kg, reassess every 250 ml, max dose 2000 ml.
ALS IV Clinical Considerations
What does PCP Assist IV authorize a PCP to do?
- “PCP Assist IV” authorizes a PCP to cannulate a peripheral IV at the request and under the direct supervision of an ACP. The patient must require a peripheral IV in accordance with the indications listed in this Medical Directive. PCPs authorized for PCP Assist IV are not authorized to administer IV fluid or medication therapy.
ALS IV Clinical Considerations
What should be considered for patients <12 years of age?
- Microdrips and/or volume control administration sets should be considered when IV access is indicated for patients <12 years of age.
Can we consider a bolus for a trauma arrest patient?
- An intravenous fluid bolus may be considered for a patient who does not meet trauma TOR criteria, where it does not delay transport and should not be prioritized over management of other reversible causes.
