Montgomery County Fire & Rescue IV Maintenance for EMTB

Transport Criteria

Reason for patient transport must not be related to the IV or medications or solutions being infused.
IV must contain only fluid permitted by Maryland Medical Protocols:
- Lactated Ringer's solution.
- 2.5% up to 10% dextrose in water.
- 0.25% up to 0.9% saline solution.
- Potassium Chloride (KCL) added to any of the above solutions not to exceed 20 milliequivilants per liter ( 20mEq/L).
- Total Parenteral Nutrition (TPN) - a patient being fed through an IV.
Confirm the appropriate drip rate prior to transport and ensure that the IV is flowing at the prescribed rate.
Ensure that the IV bag contains an adequate volume of fluid for the transport. Rule of thumb: at least 50% more fluid than necessary for a non-emergency transport to the receiving facility.
- If fluid is inadequate, have the healthcare facility replace the solution with a bag with adequate volume or have them discontinue the IV.
Patient must have no signs or symptoms of complications of IV Therapy

If IV does not meet criteria above, an appropriate level health care provider must accompany the patient in the patient compartment of the ambulance.

If appropriate healthcare provider is not available to accompany the patient, personnel at the healthcare facility need to replace the IV solution with an acceptable solution, or the IV needs to be discontinued and/or secured with a saline/heparin lock.

On a call to a residence, if the patient has a primary hospital that is not the closest hospital, transport to the patient's primary care hospital.
- Example: Child with Special Healthcare Needs is treated at Children's Hospital National Medical Center, the child should be transported there. If not reasonable to do so, consult with Children's and the receiving hospital.