BLS IV Directive

Question 1

What can we monitor?

Answer 1

1. IV TKVO
2. IV for fluid replacement with,
   * a max flow rate infused of up to 2 ml/kg/hr to a max of 200ml/hr,
   * thiamine, multivitamin preparations,
   * drugs within his/her level of certification, or
   * potassium chloride (KCl) for patients ≥18 years of age, to a max of 10mEq in a 250 mL bag.

Question 2

When do we need to request a medically responsible escort for an IV?

Answer 2

• Blood or blood product admin
• KCl for a patient who is <18 years of age
• medication other than the ones we can monitor
• when it requires electronic monitoring or uses a pressurised intravenous fluid infuser, pump, or central venous line
• for a neonate or pediatric patient <2 years of age.

Question 3

What is the BLS IV pre-transport procedure?

Answer 3

1. confirm physician’s written IV order with sending facility staff;
2. determine IV solution, flow rate, catheter gauge, catheter length, and cannulation site;
3. note condition of IV site prior to transport;
4. confirm amount of fluid remaining in bag;
5. determine amount of fluid required for complete transport time and obtain more fluid if applicable; and
6. document all pre-transport IV info on the ACR.

Question 4

What is the BLS IV procedure during transport?

Answer 4

1. monitor and maintain IV at the prescribed rate, this may include changing the IV bag as required;
2. if the IV becomes dislodged or interstitial, discontinue the IV flow and remove the catheter with particular attention to aseptic technique; and
3. confirm condition of catheter if removed.

Question 5

When should an IV bag be changed?

Answer 5

When there is approx 150 mLs remaining.