How long until you were comfortable starting an IV?

MMiz

MMiz

I put the M in EMTLife
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I live in North Carolina, the land of cheap community college, and am looking at Lenoir Community College's online EMT-Intermediate program.

It's only four months, 6 in class sessions, and $180. I'd be doing it merely for the experience.

Can a provider really learn to consistently start an IV in 6 in-class sessions and 96 hours of clinical time?
 
Yes, I think that's more than enough training. It probably took a couple of months---if that---of me being on my own as a paramedic until I was fairly confident. Now, it's typically as routine as taking a blood pressure.

I will say, when I was still a basic my old EMT school used to offer up an "ER tech" course as well. It included basic EKG interpretation, and a phlebotomy tutorial followed by clinicals at a local area hospital following around a phlebo tech for IV sticks. I think that class may have also helped my confidence with IV starts ahead of time.

With all of that, it's a pretty standard skill that comes to most providers in a fairly short amount of time.
 
I remember the Army teaching us to start IVs on each other in a 2 week CLS course back in the day, and the IV module was all of a day or 2. This was like 8 years ago now, and they've since removed IVs from CLS because they found guys when faced with a real casualty for the first time would panic and fall in on the monkey skills they were taught and go for the IV before other more important interventions (mostly airway as bleeding control was throw a tourniquet on and done). At least that's what we were told when we redid CLS 2 years ago and no IVs included. So yeah I'd say it's possible to learn IV starts in a short amount of time, but as far as overall competency goes? Whole 'nother story..
 
Looks interesting...
Additional question if anybody is aware: I am under the impression (based on the NC Scope of Practice document, see page 3) that ETI is part of AEMT/EMT-I scope of practice in NC - they can't really expect people to learn how to perform ETI with only six in class sessions, can they?
 
Sure. You can put a tube in Fred the head after a couple of tries. Competence in performing ETI on people is a whole different thing.
 
Absolutely. I think my first 15 were rough, then it clicked. Only got better from there.
 
StCEMT said:
Absolutely. I think my first 15 were rough, then it clicked. Only got better from there.
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Until you meet "Dia-Betty" with skin like a rhinoceros, no legs, a fistula in one arm, no neck, and maaaaybe a knuckle vein.
 
StCEMT said:
Absolutely. I think my first 15 were rough, then it clicked. Only got better from there.
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Most of the studies say that only after 70 or so intubation are operators baseline competent. (80% success without any outside assistance)
 
VentMonkey said:
Until you meet "Dia-Betty" with skin like a rhinoceros, no legs, a fistula in one arm, no neck, and maaaaybe a knuckle vein.
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Those took a lot more, I had to learn the finesse and tips on people like this. Like not blowing sensitive veins. But the basic AC, not missing 3/4 attempts? Yea that only took about 15 before it began leveling out. I definitely hit random slumps, but for the most part I could hit most. From there I learned alternative sites, little tips to control it, how to work with limited/short veins.

DEmedic said:
Most of the studies say that only after 70 or so intubation are operators baseline competent. (80% success without any outside assistance)
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That I believe, but I intubated significantly less than I start IV's.
 
MMiz said:
Can a provider really learn to consistently start an IV in 6 in-class sessions and 96 hours of clinical time?
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No way. Not in "real world" patients, anyway.

But I don't think being able to "consistently" start IVs is really the point of the course.
 
Yeah but in any other aemt class you won't get any more education or clinical time.
 
On the rubber arm, maybe 5.

On real human flesh, many many more.

During clinical, I logged 150 or so; and I stopped counting less than halfway through my ED rotation. I probably started at least 300.

I had the concept down fairly quickly, say less than 20. Learning the nuances took some time. The elderly, diabetics, drug users, black people etc. all have different characteristics.

I was certainly comfortable with it before finishing clinicals.
 
hometownmedic5 said:
On the rubber arm, maybe 5.

On real human flesh, many many more.

During clinical, I logged 150 or so; and I stopped counting less than halfway through my ED rotation. I probably started at least 300.

I had the concept down fairly quickly, say less than 20. Learning the nuances took some time. The elderly, diabetics, drug users, black people etc. all have different characteristics.

I was certainly comfortable with it before finishing clinicals.
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What?! Pre tell...
 
hometownmedic5 said:
You don't notice a difference?
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Honestly? No. Aside from the other diseases that I may take into account as a "difficult stick", their race has little to do with finding a decent vein in a presumably healthy individual.
 
I have noticed they frequently have tougher skin. Not universally and not insurmountable, but I have noticed it.

There's also the color disparity to consider. It's tougher to see dark veins through dark skin compared to light skin.
 
:) A smiley only because I have no words.
 
DEmedic said:
Sure. You can put a tube in Fred the head after a couple of tries. Competence in performing ETI on people is a whole different thing.
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Right, I just wouldn't want to be expected to perform ETI on people just because I can intubate Fred...
The idea that people are just thrown to the wolves to intubate is a bit frightening. (Now I'm picturing some poor medic student walking around the woods with a laryngoscope and a steak...)
 
It took me a while after school, probably 1 year on the job before I had a pretty solid success rate.
 
And the smallest thing can ruin your confidence. We recently switched catheters at my service and I am having little success with them. :/
 
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