Younger is harder: Pre-hospital IV access success rates in children

This retrospective medical record review investigated peripheral intravenous (IV) access success rates by paramedics in patients aged ≤18 years in Minnesota and Western Wisconsin from 1 January 2003 until 31 May 2011. From 2003 onwards, paramedics recorded IV attempts via an electronic medical record system, and this was used to export data for analysis. Prior to this, written records were used to verify success rates.

Statistical analysis was performed using chi-squared testing to investigate the relationship of variables such as age and gender to IV success rates. Further evaluation of the relationship of age to IV success rates was undertaken using univariate logistic regression.

During the study period, there were 261 008 ambulance responses. At least one attempt at IV access was made on 4 188 patients aged ≤18 years, representing 2% of the total response volume.

The mean age of study patients was 14.1 years and 53.4% were male. Male patients were marginally but statistically significantly more likely to have successful IV placement than females (89% versus 87%, p=0.046). The overall success rate for paediatric IV access was 88.3% (n=3699).