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    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.
    Tortella, Bartholomew J. Lavery, Robert F. Kamat, Mihir and Ramani, Mohnish 1996. Requiring On-Line Medical Command for Helicopter Request Prolongs Computer-Modeled Transport Time to the Nearest Trauma Center. Prehospital and Disaster Medicine, Vol. 11, Issue. 04, p. 261.
    Doran, James V. Tortella, Bartholomew J. Drivet, Walter J. and Lavery, Robert F. 1995. Factors Influencing Successful Intubation in the Prehospital Setting. Prehospital and Disaster Medicine, Vol. 10, Issue. 04, p. 259.
    Holliman, C.James Wuerz, Richard C. and Meador, Steven A. 1994. Decrease in medical command errors with use of a “standing orders” protocol system. The American Journal of Emergency Medicine, Vol. 12, Issue. 3, p. 279.
    Holliman, C. James Wuerz, Richard C. Miguel, Gaspar Vazquez-de and Meador, Steven A. 1994. Comparison of Interventions in Prehospital Care by Standing Orders Versus Interventions Ordered by Direct [On-line] Medical Command. Prehospital and Disaster Medicine, Vol. 9, Issue. 04, p. 202.
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Standing Orders for Field Intravenous Lines Do Not Shorten Prehospital Time in Trauma Patients

  • Bartholomew J. Tortella (a1) (a2), Robert F. Lavery (a1) (a2), Ronald P. Cody (a3) and Mindi Salant (a1) (a2) (a4)
Abstract
Study Objective:

No randomized, prospective studies have been conducted that examine how standing orders for establishing intravenous (IV) lines in trauma patients affect prehospital time. The purpose of this randomized, prospective study was to determine if standing orders for IV lines in the field shorten prehospital time.

Design:

A prospective, randomized study was conducted.

Setting:

Trauma patients (n = 521) were randomized prospectively on an even-/odd-day basis over a one-year period from 1 April 1988 to 1 April 1989. Patients were sorted into an IV Standing Orders (SO) arm (n = 258) and a No Standing Orders (NO) arm (n = 263) in which On-Line [Direct] Medical Command (OLMC) was required before IV initiation.

Participants:

Trauma patients, paramedics in a high-volume, urban, EMS system, and medical-command physicians on the trauma team at a Level 1 trauma center.

Results:

No significant differences were found in demographics, prehospital vital signs, mechanism of injury, or trauma severity scores between the two treatment arms. Scene times were similar for the two groups (IV SO = 11.4 minutes, and NO = 10.6 minutes, p = .1675) as was IV success rate (92% vs. 88%, p = .1729).

Conclusion:

When compared to OLMC in this EMS system, IV standing orders did not affect scene time. This supports the concept that only spinal stabilization and airway management be performed at the scene and other ALS maneuvers (e.g., IVs) be performed in the ambulance, preferably en route to a Trauma Center. Since IV standing orders had no documented, adverse effects and led to focused, concise radio telemetry reports, this EMS system adopted their use on a permanent basis.

Copyright
COPYRIGHT: © World Association for Disaster and Emergency Medicine 1992
Corresponding author
University Hospital, Rm. J-200, 150 Bergen Street, Newark, NJ 07103-2406 USA
Footnotes
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Presented at the annual meeting of the Eastern Association for the Surgery of Trauma, 17 January 1991.
Footnotes
References
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Prehospital and Disaster Medicine
  • ISSN: 1049-023X
  • EISSN: 1945-1938
  • URL: /core/journals/prehospital-and-disaster-medicine
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