How IV lines save lives

Small, quick and often overlooked, intravenous (IV) access is sometimes vital to saving lives – especially in pre-hospital emergency care.

Intravenous (IV) access, often called a drip, is not needed for most patients paramedics transport. But when it is required, it gives them immediate access to the circulatory system, allowing rapid treatment when time matters most, says Anel Buys, an Operational Paramedic at ER24 North Metro.

What is an IV line and when is it used?

IV access means placing a small, sterile tube into a vein – usually in the patient’s hand, arm or leg, and sometimes the neck. “In emergency care, IV lines give us immediate access to the bloodstream,” Buys says. “That access is essential when a patient’s condition is unstable or deteriorating.”

Why IV access is critical in emergencies

“Aside from intraosseous (IO) access, where medication is delivered directly into the bone, IV delivery is the fastest and most effective route for administering medication,” says Buys. “It allows us to intervene immediately in life-threatening situations.”

Whether it’s fluids to support blood pressure or medication to control pain, control bleeding or stabilise the heart, IV access enables rapid, targeted care.

When are IV lines commonly used?

IV lines are used in many emergency situations, especially when patients need fluids or medication. People with very low blood pressure, dehydration or shock may need IV fluids to improve circulation and blood flow to vital organs. Patients with traumatic injuries like fractures, may also receive IV pain relief before being moved, helping to ease pain and reduce further strain on the body.

How quickly can paramedics place an IV line?

In most cases, an IV line can be established in around two minutes.

“IV cannulation – inserting a small tube into a vein to allow fluids or medication to be given – is a core clinical skill taught early in paramedic training and practised almost daily in the field,” Buys says. “That repetition builds a high level of proficiency, even in patients with difficult venous access.”

Different types of IV and vascular access

While peripheral IV access is the most common approach, paramedics are trained to use several forms of vascular access, depending on the patient’s condition:

• Peripheral IV access: Inserted into veins of the hands, arms or legs and used in most cases.
• External jugular (EJ) access: Cannulation of a vein in the neck when peripheral access isn’t possible.
• Scalp vein cannulation: Occasionally used in infants.
• Intraosseous (IO) access: A needle inserted directly into the bone marrow, providing rapid access to circulation.

“IO access is extremely effective but painful, so it’s reserved for critical cases like cardiac arrest, severe burns or major trauma when IV access isn’t possible,” Buys explains. “For stable patients, peripheral IV access is preferable because it’s less invasive.”

Are there risks associated with IV lines?

Like any medical procedure, IV insertion carries some risk, though most complications are minor. These may include pain, bruising or bleeding at the insertion site, especially if an attempt is unsuccessful. Less commonly, more serious issues can occur, such as infection, infiltration or extravasation (fluid leaking into surrounding tissue), or significant bleeding, particularly in patients taking blood-thinning medication.

“All IV-related problems are recorded and passed on to hospital staff,” Buys notes, so the patient can be closely monitored and treated if needed.

How paramedics are trained to place IV lines safely

Paramedics receive thorough training to make sure IV lines are placed safely and correctly. During their studies, they must pass written tests and hands-on practical exams. They must also complete a set number of successful IV insertions under supervision before the Health Professions Council of South Africa (HPCSA) considers them competent.

“Ongoing practice in the field refines those skills,” says Buys. “Even experienced paramedics can encounter challenging cases, but training prepares us to adapt.”

Can IV access save lives?

Absolutely. In cases of severe blood loss, IV access allows fluids to be given immediately and life-saving medicines, such as tranexamic acid (TXA), to help reduce bleeding. It also allows administration of drugs like adrenaline to support blood pressure and help prevent cardiac arrest.

“Without IV access, those interventions wouldn’t be possible in the pre-hospital setting,” Buys says.

Supporting patients during transport

IV lines remain important while a patient is being transported to the hospital. They let paramedics keep a close eye on the patient, administer extra treatment if needed, and respond quickly if the patient’s condition worsens.

During inter-facility transfers, IV access also allows ongoing medication infusions and helps ensure care can continue immediately on arrival.

Have there been advancements in IV technology?

While IV techniques in the field haven’t changed much, hospitals are increasingly using tools like ultrasound-guided IVs and infrared vein finders. These help make insertions more accurate and successful, especially for patients whose veins are hard to find.