CP 4.14: Intravenous Initiation by Community Paramedics

Updated:
Reviewed: 

Purpose

The Community Paramedic (CP) works together with primary care providers to support patient self-care in the community whenever possible.  In some cases, patients who would otherwise self-cannulate or require cannulation for the purpose of self-administration of their medications may request assistance from the CP through the normal referral process.

Policy Statements

In response to a referral from a primary health care provider and following the standardized procedures for CP home visits, the CP may attend a client’s residence to initiate intravenous access for the purposes of patient self-administration of medications.  This procedure does not include CP administration of any medications.

Such patient interactions will follow the same patient referral, intake, management, and documentation processes as any other CP wellness check.

It is expected that the CP will document the procedure, including all findings, and report them to the primary health care provider and collaborate with other health care team members to provide support as appropriate.

Procedure

1. OBTAIN and REVIEW patient’s health history and care plan prior to appointment.
2. REFER to Request for Service form and care plan with respect to assessment, patient specific care interventions, and patient teaching as required.
3. EXPLAIN the purpose of the visit and OBTAIN verbal consent prior to undergoing any procedure, including vital signs.
4. PERFORM physical exam including:
   • Vital signs (T, P, RR, BP)
   • Pulse oximetry
   • Level of consciousness
5. ASSESS patient's understanding of the procedure and DISCUSS any concerns the patient may have prior to cannulation.

6. CONFIRM patency of IV access by flushing with normal saline and secure the catheter.  REVIEW possible complications with patient and verify understanding of when follow up care from the primary care provider would be required.

   If first 2 attempts to secure IV access are unsuccessful, contact the patient’s care team for revised care plan (i.e., direction to continue/discontinue, higher level of care, alternate strategies).
7. DOCUMENT the visit and all assessments/treatments on your ePCR as per standard procedure.
8. COMMUNICATE with the primary care provider or health care team as noted on care plan or if any other concerns arise.
   
   

Documentation

DOCUMENT details of the visit on the CP progress notes and notify primary health care provider or health care team of findings and any concerns.

References