Locks are no longer heparinized in the U.S. as a routine. They are flushed with 3-10ml of NSS, which prevents clotting. The main point in my EMS as per Medical Control is almost everyone with significant history gets a line. No need in "hanging fluids", even if they need medications, one can "flush" after the medication.
In my specific area, a Basic EMT can monitor IV saline locks and even IV's that are at a TKO rate, as long as there is no medication(s) added to.
In U.S. most EMS, the billing is unique. Unless there is a medication, it is not considered a ALS call. After the administration of two or more separate medications, then it is a ALS II, which increases the rate. Now, as usual there is significant rules such as the medication cannot be, for example two NTG sprays. (One reason, is a Basic can assist in administration) as well two ASA.
The emergency level is regard on how the call was received, not how the call was per say initially was. So one can charge emergency (911) for chest pain and administer NTG, Oxygen, ECG, IV (with or without lock) and it would be an ALS I, if you did the same but administered anti-emetic and i.e Morphine Sulfate, it would be an ALS II response. Different in pay structure. As well most EMS reimburse in captitated rates, as "group sum" not individual expenses.. IV needle, tubing, etc. An agreement between provider and payer, that an ALS I would be $XYZ amount and ALSII would be an $ABC amount, for say an average costs. So each time the amount is the same. It usually equals out.
R/r 911
