Comparison of Clinically Significant Infection Rates Among Prehospital- Versus In-Hospital-Initiated IV Lines

Robert Levine, Daniel W Spaite, Terence D Valenzuela, Elizabeth A. Criss, A. Lawrence Wright, Harvey W Meislin

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Study objective: To compare the risk of infection for IV lines placed in the prehospital versus in the in-hospital setting in a midsized emergency medical service system. Design: A retrospective analysis was made of all IV line site infections among patients admitted to ward beds from a university hospital emergency department in 1992. Methods: The hospitals infection control team conducted daily ward rounds and a surveillance of all wound and blood cultures. Patients with signs and/or symptoms consistent with Centers for Disease Control and Prevention guidelines for skin and soft tissue infection were reported to the responsible medical team. Infections were documented based on consensus opinion between the infection control team and the physicians responsible for the care of the patient. IV lines placed in the prehospital phase of care were identified by electronic retrieval from the prehospital database. Results: Three thousand one hundred eighty-five patients who had a prehospital or an in-hospital IV line placed were admitted from the ED. Eight hundred fifty-nine IV lines were prehospital placed (27%), and 2,326 were in-hospital placed (73%). There was one infection in the prehospital group and four in the in-hospital group (infection rate: .0012 for prehospital patients and .0017 for in-hospital patients; P =.591 by Fishers exact test). Conclusion: Both cohorts had exceptionally low infection rates. No clinically or statistically significant increase in the risk of infection among prehospital- or in-hospitalinitiated IV lines was identified. [Levine R, Spaite DW, Valenzuela TD, Criss EA, Wright AL, Meislin HW: Comparison of clinically significant infection rates among prehospital- versus in-hospitalinitiated IV lines. Ann Emerg Med April 1995;25:502-506.].

Original languageEnglish (US)
Pages (from-to)502-506
Number of pages5
JournalAnnals of Emergency Medicine
Volume25
Issue number4
DOIs
StatePublished - 1995
Externally publishedYes

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Infection
Infection Control
Cross Infection
Soft Tissue Infections
Hospital Departments
Emergency Medical Services
Centers for Disease Control and Prevention (U.S.)
Signs and Symptoms
Hospital Emergency Service
Patient Care
Databases
Guidelines
Physicians
Skin
Wounds and Injuries

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Comparison of Clinically Significant Infection Rates Among Prehospital- Versus In-Hospital-Initiated IV Lines. / Levine, Robert; Spaite, Daniel W; Valenzuela, Terence D; Criss, Elizabeth A.; Wright, A. Lawrence; Meislin, Harvey W.

In: Annals of Emergency Medicine, Vol. 25, No. 4, 1995, p. 502-506.

Research output: Contribution to journalArticle

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abstract = "Study objective: To compare the risk of infection for IV lines placed in the prehospital versus in the in-hospital setting in a midsized emergency medical service system. Design: A retrospective analysis was made of all IV line site infections among patients admitted to ward beds from a university hospital emergency department in 1992. Methods: The hospitals infection control team conducted daily ward rounds and a surveillance of all wound and blood cultures. Patients with signs and/or symptoms consistent with Centers for Disease Control and Prevention guidelines for skin and soft tissue infection were reported to the responsible medical team. Infections were documented based on consensus opinion between the infection control team and the physicians responsible for the care of the patient. IV lines placed in the prehospital phase of care were identified by electronic retrieval from the prehospital database. Results: Three thousand one hundred eighty-five patients who had a prehospital or an in-hospital IV line placed were admitted from the ED. Eight hundred fifty-nine IV lines were prehospital placed (27{\%}), and 2,326 were in-hospital placed (73{\%}). There was one infection in the prehospital group and four in the in-hospital group (infection rate: .0012 for prehospital patients and .0017 for in-hospital patients; P =.591 by Fishers exact test). Conclusion: Both cohorts had exceptionally low infection rates. No clinically or statistically significant increase in the risk of infection among prehospital- or in-hospitalinitiated IV lines was identified. [Levine R, Spaite DW, Valenzuela TD, Criss EA, Wright AL, Meislin HW: Comparison of clinically significant infection rates among prehospital- versus in-hospitalinitiated IV lines. Ann Emerg Med April 1995;25:502-506.].",
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