Success factors of peripheral Intravenous catheterization for EMTs of local fire departments in Japan

Journal of Japanese Society for Emergency Medicine 26th, 2023, Tokyo.

[Background] Peripheral intravenous catheterization (PIVC) is carried out by paramedics in three specific conditions: cardiopulmonary arrest, shock, and hypoglycemia. Investigating the factors that impact the success or failure of PIVC could potentially enhance the overall success rate of this procedure.
[Purpose] The aim of this study is to analyze the key factors influencing the outcomes of PIVC attempts conducted by paramedics within local fire departments.
[Methods] In this retrospective study, we assessed the PIVC trial outcomes (n = 774) across three regions within Miyazaki Prefecture during the time span from January 1, 2020, to December 31, 2020.
[Results] The number of PIVC trials (Adjusted Odds Ratio [AOR] = 2.79, 95% Confidence Interval [CI] = 1.47-5.29; p < 0.01), cases involving shock (AOR = 1.73, 95% CI = 1.03-2.92; p < 0.05), and rural settings (AOR = 1.87, 95% CI = 1.02-3.43; p < 0.05) were all correlated with an increased PIVC success rate. Conversely, extrinsic diseases (AOR = 0.58, 95% CI = 0.34-0.98; p < 0.05), targeting the ulnar cutaneous vein (AOR = 0.40, 95% CI = 0.19-0.85; p < 0.05), and engagement in rescue team coordination activities (AOR = 0.10, 95% CI = 0.02-0.60; p < 0.05) were linked to lower rates of PIVC success.
[Conclusion] The analysis suggests that victim-related factors (Area Under the Curve [AUC] = 0.63, 95% CI = 0.58-0.69) may exert a more substantial influence on the success or failure of PIVC in comparison to practitioner-related factors (AUC = 0.57, 95% CI = 0.51-0.62) and environmental factors (AUC = 0.58, 95% CI = 0.52-0.64). This underscores the significance of patient-related considerations in determining the outcomes of PIVC procedures.