Shoul an RN delegate IV insertion to a paramedic?

Question

As applicable to Texas law. Emergency setting.

Answer 1

Once a patient has been admitted to the ED department a paramedic is outside the scope of his practice, thus although he can insert an IV in the field he CAN NOT insert one in the ED setting. For all those who "think" they can, check out your hospitals policies and procedures, you will find that this is out of a medics scope of practice (although it is done, if the administration or charge nurse finds out this could create problems).

Answer 2

It depends....

In an out of hospital emergency setting, paramedics start IV's all the time. There's no problem in a nurse delegating the IV start to a paramedic, assuming the paramedic is licensed to work in Texas. If it's one of those random emergency scenes (car accident on the side of the road) and the nurse just stopped to help, and some random plain clothes person comes up to help and says he's a paramedic, I woudn't let him start the IV because of legal issues (there's no way to verify his certification, and most paramedics are not allowed to practice ALS skills unless working). If the paramedic is a crewmember of an ambulance that stopped to help, then there's no problem in letting him start the IV. Most likely he will start it anyways, being that once the ambulance arrives onscene, the paramedics get to be in charge of the scene (unless there's a physician there).

If the emergency is in-hospital, it really depends on who employs the paramedic and the laws of the individual state. If the paramedic is employed by the hospital (hospital based ambulance service) then he's usually completely OK to start IV's. The vast majority of paramedics in hospital based services are actually required to help out in the ER as techs when things get busy. If it's not a hospital based service, then it depends on the paramedic's medical director. Remember, a paramedic's license is an extension of the physician medical director's medical license. If they say it's OK, then it's OK. I've started IV's in a critical situation on a hospital patient and as long has I had the OK from a med control physician, I considered it OK. No where in my protocols does it say I'm not allowed to do it :)
Paramedics are very frequently employed as ER techs in many hospitals around the US. They are allowed to do nearly everything an RN can do, and that includes IV starts. Once a patient is admitted to the hospital, he does not become out of the scope of a paramedic's practice. The role of the paramedic just changes, from being the primary provider of care, to an ER tech role. A paramedic employed as an ER tech will act in a different role than a paramedic working in the field.

Hope this helps...

Answer 3

Not from texas, but I was in the hospital once and the RNs couldn't get a line in, so they paged a paramedic who did it on his first try. I don't know if the person you have in mind was experienced, but I know that many paramedics are very good at this because they have to be able to do it quickly in less than ideal circumstances. In my own experience, I'm glad the RN delegated this duty.

Answer 4

Both are qualified to start an IV, so if the nurse's skills are better served in another capacity during this emergency setting, such delegation would be appropriate. In my experience, many paramedics are quite proficient at starting a line in even the most awkward of circumstances.

Answer 5

Yes, an RN can delegate an IV insertion to a paramedic. It is within his scope of practice anyway. Doesn't matter which state. And he might be better since he puts them in often.

Answer 6

I am a emt.. And I think Yea If a paramedic can get it or a emt.. let them.. WE have to be fast on our feet.. and know more then what people think we do..