Abstract
INTRODUCTION: Two new conditions for intravenous approach (IVA) were approved in emergency medical technicians (EMTs) by revision of licensing act in 2014. Before revision of this act in Japan, IVA was permitted to EMTs only at emergency occasion such as cardiopulmonary arrest (CPA). The new conditions for IVA comprise of glucose infusion for hypoglycemia and fluid infusion for hypotension both requiring immediate resuscitation and available only by well-trained EMTs on IVA techniques. These new conditions are expected to create more chances for EMTs to improve their skills in IVA and result in increasing success rate of IVA at out-of-hospital setting METHOD: Emergency rescue records (Utstein style data) collected from Ibaraki Seinan Fire Department, Ibaraki prefecture, Japan, from 2014 to 2016 were retrospectively analyzed by chi-square test to identify change in the success rate of IVA infusion before and after revision of the act. Data of 2014 and 2016 were compared due to the reason that emergency rescue program revised to comply with the new act started to function from 2016 in this region. RESULT: After revision in the program, chances for EMTs to set up IVA increased by 34%. Along with it, overall success rate of IVA significantly increased from 52.2% in 2014 to 63.2% in 2016, (p<0.01). Even for CPA cases, the success rate of IVA increased from 52.2% to 63.8% (p<0.01). Infusion success rate after revision was highest (78.5%) in hypoglycemic cases and lowest in CPA cases (58.5%). CONCLUSION: Expanding conditions for EMTs on IVA set-up created more chances for these people to operate in actual setting, which resulted not only in the increased IVA success in new conditions but also in more difficult and extreme CPA conditions.
