IV given at scene may worsen outcome

BALTIMORE, Jan. 11 (UPI) -- Patients given intravenous fluids before transport to a hospital are significantly more likely to die than those not given an IV, U.S. researchers say.

Study leader Dr. Elliott R. Haut of the Johns Hopkins University School of Medicine says mandating pre-hospital IV fluids for all trauma patients -- required in many states -- should be discouraged.

IV fluids have been given for decades to trauma victims whose blood pressure has sharply decreased due to blood loss, because it was believed fluids quickly raise dangerously low blood pressure to keep the body's systems working, Haut says.

However, there is some evidence that IV fluids may actually be making matters worse in those patients in whom very low blood pressure temporarily stops bleeding, and rapidly raising blood pressure can cause them to start bleeding again.

"Giving IV fluids to patients before they go to the hospital can delay transport," Haut says in a statement. "Our study suggests it may be better to get patients to the hospital faster."

Haut and colleagues examined data from 776,734 trauma patients from 2001 to 2005, primarily male, white and under age 40. About half were given IV fluids at the scene.

The study, scheduled to be published in the Annals of Surgery, found patients given IV fluids were 11 percent more likely to die than those who were not. The figure was 25 percent higher for those who were shot or stabbed, 35 percent for those who had severe head injuries and 35 percent for those who got emergency surgery once hospitalized.