Vein cannulation success rates by German paramedics: a single-centre study

Abstract

Gaining intravenous (IV) access is vulnerable to errors and failure, and this study analysed IV procedures by paramedics in the federal state of Hesse in Germany to examine these. This was a single-centre, observational, pilot study survey on gaining vascular access. As well as identifying the success and failure rate of IV attempts, factors associated with a higher risk of failure were analysed using logistic regression, Χ2 or Fisher's exact test. A total of 207 vascular access attempts were included in the analysis, of which 90.34% were successful. Significantly associated with higher risk of failure were patients' age (OR 1.05; 95% (CI 1.02–1.10); p=0.041), or when two (OR 3.94; 95% CI (2.39–6.20); p≤0.001) or more than three attempts (OR: 3.26 [95% CI: 1.35; 5.17]; p=0.003) were needed rather than one. In contrast, risk of failure was significantly lower when patients indicate a good (OR 0.02; 95% CI (0.00–0.15); p≤0.001) or moderate (OR 0.04 (95% CI 0.01–0.17); p≤0.001) vein status compared to a bad vein status. Failure rates were higher when paramedics were working a night shift (OR 0.06; 95% CI (0.00–0.98); p=0.005) rather then during the day. A proportion of IV access attempts by paramedics are unsuccessful and, if paramedics are to provide invasive interventions, non-IV options for drug administration should be available.