Can an PCP without AIV monitor a fluid bolus?

No. If an AIV PCP or ACP initiates an IV fluid bolus, that paramedic should remain with the patient and continue to manage the fluid therapy during transport. An active bolus is an AIV or ACP-level intervention and requires ongoing reassessment of the indication, volume administered, patient response, infusion rate, and evidence of fluid overload. The ALS PCS states that the paramedic most appropriate for an intervention is expected to remain responsible for the patient, and that care may only be assigned to another paramedic when it is within that paramedic’s scope of practice.

The caveat is when the fluid bolus has been completed and the IV has been reduced to a TKVO maintenance rate. A non-AIV PCP may monitor and maintain an established isotonic crystalloid infusion at the permitted TKVO rate. Transfer back to the non-AIV PCP crew would remain dependent on the patient being clinically stable and not otherwise requiring AIV or ACP-level assessment or treatment.

References

Advanced Life Support Patient Care Standards, Version 5.4:

• Preamble, Responsibility for Care, page 7.
• Intravenous and Fluid Therapy Medical Directive, pages 91 to 93.

Basic Life Support Patient Care Standards, Version 3.4:

• Intravenous Line Maintenance Standard, pages 59 to 60.