Basic-Level Emergency Medical Technician Administration of Fluids and Glucose via Enzyme-Assisted Subcutaneous Infusion Access

During disasters and mass-casualty incidents (MCIs), there may be insufficient numbers of advanced life support (ALS) providers to provide intravenous (IV) access to all patients requiring parenteral fluids and/or medications. Enzyme-assisted subcutaneous infusion (EASI) access, in which human recom...

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Veröffentlicht in:Prehospital and disaster medicine 2012-06, Vol.27 (3), p.220-225
Hauptverfasser: Soremekun, Olanrewaju A., Shear, Melissa L., Connolly, Jay, Stewart, Charles E., Thomas, Stephen H.
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container_start_page 220
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creator Soremekun, Olanrewaju A.
Shear, Melissa L.
Connolly, Jay
Stewart, Charles E.
Thomas, Stephen H.
description During disasters and mass-casualty incidents (MCIs), there may be insufficient numbers of advanced life support (ALS) providers to provide intravenous (IV) access to all patients requiring parenteral fluids and/or medications. Enzyme-assisted subcutaneous infusion (EASI) access, in which human recombinant hyaluronidase (HRH) augments subcutaneous fluid dispersion and absorption, may be useful when ALS resources are insufficient to meet intravascular access needs. The utility of the use of the EASI lies, in part, in its ease of placement by ALS personnel. The objectives of this study were to document the feasibility, comfort, and speed/degree of infused-glucose uptake through EASI lines placed by basic-level emergency medical technicians (EMT-Bs). Eighteen EMT-Bs instituted EASI access on each other. A total of 150 units (1 mL) of HRH were administered through the EASI line, followed by the administration of 250 mL of tracer-labeled D5W. Timed phlebotomy enabled gas chromatography/mass spectrometry characterization of glucose uptake. Enzyme-assisted subcutaneous infusion placement and comfort ratings were tracked and analyzed using non-parametric statistics and Fisher's Exact Test. In all 18 subjects, EASI access required only one attempt and was rated by the EMT-Bs as easy to accomplish. Glucose was absorbed quickly (within five minutes) in all subjects. The rate of infusion was rapid (median 393 mL/hour) and was comfortable for the recipients (median pain score 1/10). The use of EASI may be viable as a fast, simple, and reliable method for the administration of fluid and glucose by EMT-Bs.
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subjects Adult
Catheterization, Peripheral - methods
Emergency medical care
Emergency Medical Services
Emergency Medical Technicians
Feasibility Studies
Female
Fluid Therapy - methods
Gas chromatography
Gas Chromatography-Mass Spectrometry
Glucose - administration & dosage
Health technology assessment
Humans
Hyaluronoglucosaminidase - administration & dosage
Infusions, Subcutaneous
Male
Mass spectrometry
Middle Aged
Parenteral nutrition
Recombinant Proteins - administration & dosage
Technicians
title Basic-Level Emergency Medical Technician Administration of Fluids and Glucose via Enzyme-Assisted Subcutaneous Infusion Access
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