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intraosseus access

Boulos S Nassar, Richard Kerber
Cardiac arrest continues to represent a public health burden with most patients having dismal outcomes. CPR is a complex set of interventions requiring leadership, coordination, and best practices. Despite the widespread adoption of new evidence in various guidelines, the provision of CPR remains variable with poor adherence to published recommendations. Key steps health-care systems can take to enhance the quality of CPR and, potentially, to improve outcomes, include optimizing chest compressions, avoiding hyperventilation, encouraging intraosseous access, and monitoring capnography...
November 2017: Chest
Andrzej Kurowski, Dariusz Timler, Togay Evrin, Ɓukasz Szarpak
BACKGROUND: The study was designed to investigate the success rate and time of insertion intraosseous access during simulated resuscitation. MATERIAL AND METHODS: This was a randomized crossover study involving 107 paramedics. They were timed from start of insertion attempt to successful insertion and asked to score perceived difficulty of intraosseus access devices. Bone injection gun (BIG) (WaisMed Company, Houston, TX), EZ-IO (Vidacare, Shavano Park, TX) and Jamshidi (Carefusion, San Diego, CA) were used in this study...
December 2014: American Journal of Emergency Medicine
Christopher L Moore
Vascular access is the most commonly performed invasive procedure in medicine. For more than 20 years, ultrasound has been shown to improve the success and decrease complications of central venous access; however, it is still not universally used for this procedure. Ultrasound may also be used to facilitate difficult peripheral vascular access, potentially avoiding other more invasive procedures such as central or intraosseus vascular access. This article reviews some of the indications and evidence for ultrasound-guided vascular access, provides tips for successful ultrasound guidance, and discusses barriers to adoption...
July 2014: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Gemma C Lewis, Stephanie A Crapo, Jefferson G Williams
The venous and/or arterial vasculature may be accessed for fluid resuscitation, testing and monitoring, administration of blood product or medication, or procedural reasons, such as the implantation of cardiac pacemaker wires. Accessing the vascular system is a common and often critically important step in emergency patient care. This article reviews methods for peripheral, central venous, and arterial access and discusses adjunct skills for vascular access such as the use of ultrasound guidance, and other forms of vascular access such as intraosseus and umbilical cannulation, and peripheral venous cut-down...
February 2013: Emergency Medicine Clinics of North America
M Helm, B Hossfeld, T Schlechtriemen, J Braun, L Lampl, M Bernhard
BACKGROUND: Intraosseous infusion has become established as a fast and safe alternative to conventional vascular access in emergency situations. Originally the use of intraosseous access was limited to children up to 6 years of age and to adults for cardiopulmonary resuscitation but this limitation has now been removed. The aim of this study was to obtain data on mission reality regarding the use of intraosseous access in the prehospital setting against the background of the expanded recommendations on the use of the intraosseous infusion...
December 2011: Der Anaesthesist
E J Hulse, G O R Thomas
Timely and appropriate access to the vascular circulation is critical in the management of 21st century battlefield trauma. It allows the administration of emergency drugs, analgesics and rapid replacement of blood volume. Methods used to gain access can include; the cannulation of peripheral and central veins, venous cut-down and intraosseus devices. This article reviews the current literature on the benefits and complications of each vascular access method. We conclude that intraosseus devices are best for quick access to the circulation, with central venous access via the subclavian route for large volume resuscitation and low complication rates...
December 2010: Journal of the Royal Army Medical Corps
Bastiaan M Gerritse, Gert Jan Scheffer, Jos M Th Draaisma
BACKGROUND: To evaluate the use of the bone injection gun to obtain vascular access in the prehospital setting by an Helicopter-Transported Emergency Medical Team. METHODS: Prospective descriptive study to assess the frequency and success rate of the use of the bone injection gun in prehospital care by a Helicopter-Transported Emergency Medical Team. RESULTS: In 40 of 780 (5.1%) patients, an attempt was made to obtain intraosseous access with the bone injection gun...
June 2009: Journal of Trauma
Amin B Kassam, Ajith J Thomas, Lee A Zimmer, Carl H Snyderman, Ricardo L Carrau, Arlan Mintz, Michael Horowitz
OBJECTIVE AND IMPORTANCE: Vascular lesions with an intraosseus nidus involving the skull base are uncommon and challenging [Gianoli GJ, Amedee RG Vascular malformation of the sphenoid sinus. Ear Nose Throat J. 70:373-375;(1991), Malik GM, Mahmood A, Mehta BA Dural arteriovenous malformation of the skull base with intraosseous vascular nidus. Report of two cases. J. Neurosurg 81:620-623;(1994)]. We present a pediatric patient, with a life-threatening arteriovenous malformation (AVM) of the sphenoid sinus, clivus, and ventral skull base, who failed routine multimodality management of AVMs...
May 2007: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Russell J Boyd, Jackie Schutz, Peter Stuart
OBJECTIVES: This study was designed to investigate the success rate, time for insertion and perceived difficulty in gaining intraosseus access in a porcine-derived animal model. The model was selected to have bone characteristics similar to human adult bone. Prehospital care personnel used two varieties of commercially available intraosseus needles, Cook Paediatric Intraosseus Insertion Needles and Cook Osteo-site needles. METHODS: Sixteen ambulance paramedic trainees were trained to use both of two intraosseus needle types...
August 2003: Emergency Medicine
M W Beal, D Hughes
Acquisition of vascular access in the emergent small animal patient is one of the keys to successful management of a population of patients that are often unstable with regard to their major body systems. Venous and intraosseus cannulation allow for the administration of a variety of fluids and potentially life-saving medications. In addition, central venous and arterial access also serve as conduits for atraumatic blood sampling and intravascular pressure monitoring. A thorough knowledge of vascular access theory, the dynamics of fluid flow, vascular anatomy, catheter selection criteria, and placement techniques are critical to the proper and safe use of the vascular access options available today to the small animal clinician...
May 2000: Clinical Techniques in Small Animal Practice
J J Vyskocil, J A Kruse, R F Wilson
When a patient requires parenteral fluid or drug administration and venous cannulation cannot be performed, consider less typical routes. Intraosseus infusions are usually more effective in children than adults, but intraosseus cannulation failure may occur in as many as 20% of patients. Intra-arterial infusions are possible if pump pressures are kept high. Hypodermoclysis (infusion into the subcutaneous tissues) can correct moderate dehydration. Administering resuscitative drugs endobronchially is usually safe and effective, although pulmonary function may be somewhat compromised...
April 1993: Journal of Critical Illness
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