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Intraosseous access

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https://www.readbyqxmd.com/read/29310869/intraosseous-vascular-access-is-associated-with-lower-survival-and-neurologic-recovery-among-patients-with-out-of-hospital-cardiac-arrest
#1
Takahisa Kawano, Brian Grunau, Frank X Scheuermeyer, Koichiro Gibo, Christopher B Fordyce, Steve Lin, Robert Stenstrom, Robert Schlamp, Sandra Jenneson, Jim Christenson
STUDY OBJECTIVE: We seek to determine the effect of intraosseous over intravenous vascular access on outcomes after out-of-hospital cardiac arrest. METHODS: This secondary analysis of the Resuscitation Outcomes Consortium Prehospital Resuscitation Using an Impedance Valve and Early Versus Delayed (PRIMED) study included adult patients with nontraumatic out-of-hospital cardiac arrests treated during 2007 to 2009, excluding those with any unsuccessful attempt or more than one access site...
January 6, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29300281/the-ios-have-it-a-prospective-observational-study-of-vascular-access-success-rates-in-patients-in-extremis-using-video-review
#2
Kristen M Chreiman, Ryan P Dumas, Mark J Seamon, Patrick K Kim, Patrick M Reilly, Lewis J Kaplan, Jason D Christie, Daniel N Holena
BACKGROUND: Quick and successful vascular access in injured patients arriving in extremis is crucial to enable early resuscitation and rapid OR transport for definitive repair. We hypothesized that intraosseous (IO) access would be faster and have higher success rates than peripheral IVs (PIVs) or central venous catheters (CVCs). METHODS: High-definition video recordings of resuscitations for all patients undergoing Emergency Department Thoracotomy (EDT) from 4/2016-7/2017 were reviewed as part of a quality improvement initiative...
January 4, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29194320/no-iv-no-problem-intraosseous-administration-of-tranexamic-acid-is-as-effective-as-intravenous-in-a-porcine-hemorrhage-model
#3
Michael S Lallemand, Donald M Moe, John M McClellan, Michael Loughren, Shannon Marko, Matthew J Eckert, Matthew J Martin
BACKGROUND: The acute coagulopathy of trauma is often accompanied by hyperfibrinolysis. TXA can reverse this phenomenon, and, when given early, decreases mortality from bleeding. Establishing IV access can be difficult in trauma and IO access is often preferred for drug administration. Currently, there is no data on the efficacy of IO administered TXA. Our objectives were to compare serum concentrations of tranexamic acid (TXA) when given IV and intraosseous (IO) and to compare the efficacy of IO administered TXA to IV at reversing hyperfibrinolysis METHODS: Using a porcine hemorrhage and ischemia-reperfusion (IR) model, 18 swine underwent hemorrhagic shock followed by a tissue plasminogen activator (tPA) infusion to induce hyperfibrinolysis...
December 1, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29170348/51%C3%A2-paediatric-emergency-clinicians-are-rarely-exposed-to-non-airway-critical-procedures-a-predict-pern-study
#4
Juan P Garrahan, Mark Lyttle, Ed Oakley, Stuart Dalziel, Lucia Nguyen, Arjun Rao, Santiago Mintegi, Franz Babl
BACKGROUND: Recent studies suggest that approximately one per thousand paediatric ED attendances may require some sort of critical procedure, with intubation being by far the most common. It is unknown how often critical non-airway procedures such as chest decompression, CPR, ED thoracotomy, defibrillation, pacing, and advanced vascular access techniques are performed by paediatric emergency clinicians. OBJECTIVE: To determine the recent performance or supervision, and confidence for various paediatric critical non-airway procedures by senior paediatric emergency clinicians...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29125229/observational-review-of-paediatric-intraosseous-needle-placement-in-the-paediatric-emergency-department
#5
Elysha L Pifko, Amanda Price, Carrie Busch, Curren Smith, Yunyun Jiang, Joseph Dobson, Rachel Tuuri
AIM: Intraosseous (IO) access is a life-saving option during resuscitations in the paediatric emergency department (PED). This study aimed to compare success rates and time to placement for Manual IO versus EZ-IO needles in PED patients ≤8 and >8 kg. METHODS: This was a retrospective cross-sectional descriptive study of IO use in a single-centre tertiary PED from 2006 to 2014. Cases were identified through diagnosis codes for IO infusion, cardiopulmonary resuscitation and cardiac arrest and admissions to the intensive care unit...
November 10, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29033730/intentional-intra-arterial-injection-of-midazolam-in-a-patient-with-status-epilepticus-in-the-intensive-care-unit
#6
Muhammad Asghar Ali, Muhammad Yahya
Fundamental medical care includes intravenous (IV) access which provides prompt resuscitation and reliable delivery of analgesics, antibiotics, and vasoactive medication. Difficult access populations, especially in critical area, continue to challenge providers to consider and utilize alternative means to provide IV access. Potential options under such circumstances include intramuscular, intraosseous, and intratracheal drug administration, but in extreme cases where no other options are available, intra-arterial route might be considered...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28940706/applied-anatomy-for-tibial-intraosseous-access-in-adults-a-radioanatomical-study
#7
Onur Polat, Ahmet Burak Oguz, Muge Gunalp Eneyli, Ayhan Comert, Halil Ibrahim Acar, Eray Tuccar
Intraosseous access is a method for providing vascular access in resuscitation of critically ill and injured patients when traditional intravenous access is difficult or impossible. There is a lack of detailed description for the landmark for the insertion point in the literature. The aim of this study was to determine the exact location for intraosseous access. Radiographic computed tomography (CT) images of a total of 50 dry tibia bones were obtained. With 5-mm intervals, for all transverse images and by selecting transverse section, measurements were taken from the thickness of the cortex at anterior margin and mid-line medial surface, distance from anterior margin, and mid-line medial surface of the tibia to the posterior wall of medullar cavity, distance from anterior margin and mid-line medial surface of the tibia to the posterior surface of the tibia...
September 22, 2017: Clinical Anatomy
https://www.readbyqxmd.com/read/28893316/intraosseous-blood-samples-for-point-of-care-analysis-agreement-between-intraosseous-and-arterial-analyses
#8
Milla Jousi, Simo Saikko, Jouni Nurmi
BACKGROUND: Point-of-care (POC) testing is highly useful when treating critically ill patients. In case of difficult vascular access, the intraosseous (IO) route is commonly used, and blood is aspirated to confirm the correct position of the IO-needle. Thus, IO blood samples could be easily accessed for POC analyses in emergency situations. The aim of this study was to determine whether IO values agree sufficiently with arterial values to be used for clinical decision making. METHODS: Two samples of IO blood were drawn from 31 healthy volunteers and compared with arterial samples...
September 11, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28836037/intramedullary-placement-of-ventricular-shunts-a-review-of-using-bone-as-a-distal-cerebrospinal-absorption-site-in-treating-hydrocephalus
#9
REVIEW
Mohammad W Kassem, Joshua Chern, Marios Loukas, R Shane Tubbs
PURPOSE: Intraosseous (IO) vascular access has been used since the Second World War and is warranted when there is an emergency and/or urgent need to replenish the vascular pool. Despite long-term and satisfactory results from delivering large quantities of intravenous fluid via the medullary space of bone, use of this space for a distant receptacle for cerebrospinal fluid (CSF) diversion has seldom been considered. METHODS: The current paper reviews the literature regarding the bony medullary space as a receptacle for intravenous fluid and CSF...
December 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28796429/comparison-of-time-to-obtain-intraosseous-versus-jugular-venous-catheterization-on-canine-cadavers
#10
Alison R Allukian, Amanda L Abelson, Jonathan Babyak, Elizabeth A Rozanski
OBJECTIVE: To compare the time required and the success rate of personnel with 4 different levels of experience to place a humeral intraosseous (IO) catheter versus a jugular venous catheter (IV) in cadaver dogs. DESIGN: Prospective study. SETTING: Veterinary university teaching hospital. INTERVENTIONS: Canine cadavers from recently euthanized dogs were obtained from the cadaver donation program between May and December 2014...
September 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28745852/vascular-access-in-pediatric-patients-in-the-emergency-department-types-of-access-indications-and-complications-digest
#11
Rachel Whitney, Melissa Langhan, Kathryn H Pade
Vascular access is a potentially life-saving procedure that is a mainstay of emergency medicine practice. There are a number of challenges associated with obtaining and maintaining vascular access, and the choice of the route of access and equipment used will depend on patient- and provider-specific factors. In this issue, the indications and complications of peripheral intravenous access, intraosseous access, and central venous access are reviewed. Timely and effective assessment and management of difficult-access patients, pain control techniques that can assist vascular access, and contraindications to each type of vascular access are also discussed...
June 22, 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28739613/soft-tissue-laceration-caused-by-lower-extremity-intraosseous-access-insertion-in-an-obese-patient
#12
Romina Bromberg, Kairavee Dave, Dhruti Mankodi, Mauricio Danckers
No abstract text is available yet for this article.
July 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28705570/la-pose-de-voie-veineuse-p%C3%A3-diatrique-par-les-%C3%A3-quipes-de-smur-adultes
#13
REVIEW
Frédéric Lemoine, Hugues Lefort, Sabine Lemoine, Benoît Frattini, Daniel Jost
Paediatric perfusion during pre-hospital care is a major issue in the event of life-threatening emergencies. Access, often restricted, to backup specialising in paediatrics, implies the existence of practices on protocols for the adult mobile emergency and intensive care service (Smur) in partnership with paediatricians. Paediatric perfusion practices were assessed in these teams. The results show the presence of a paediatric protocol in the adult Smur teams is not very common. Nursing practices seem to be evolving towards the recommendations, thanks to technological advances such as the use of the intraosseous device...
July 2017: Soins. Pédiatrie, Puériculture
https://www.readbyqxmd.com/read/28644688/intraosseous-administration-of-antidotes-a-systematic-review
#14
Audrée Elliott, Pierre-André Dubé, Amélie Cossette-Côté, Laura Patakfalvi, Eric Villeneuve, Martin Morris, Sophie Gosselin
CONTEXT: Intraosseous (IO) access is an established route of administration in resuscitation situations. Patients with serious poisoning presenting to the emergency department may require urgent antidote therapy. However, intravenous (IV) access is not always readily available. OBJECTIVE: This study reviews the current evidence for IO administration of antidotes that could be used in poisoning. The primary outcome was mortality as a surrogate of efficacy. Secondary outcomes included hemodynamic variables, electrocardiographic variables, neurological status, pharmacokinetics outcomes, and adverse effects as defined by each article...
June 23, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28629995/intraosseous-compared-to-intravenous-drug-resuscitation-in-out-of-hospital-cardiac-arrest
#15
Bryan A Feinstein, Benjamin A Stubbs, Tom Rea, Peter J Kudenchuk
AIMS: Although the intraosseous (IO) route is increasingly used for vascular access in out-of-hospital cardiac arrest (OHCA), little is known about its comparative effectiveness relative to intravenous (IV) access. We evaluated clinical outcomes following OHCA comparing drug administration via IO versus IV routes. METHODS: This retrospective cohort study evaluated Emergency Medical Services (EMS)-treated adults with atraumatic OHCA in a large metropolitan EMS system between 9/1/2012-12/31/2014...
August 2017: Resuscitation
https://www.readbyqxmd.com/read/28599052/tccc-updates-two-decades-of-saving-lives-on-the-battlefield-tactical-combat-casualty-care-turns-20
#16
Frank K Butler
BACKGROUND: Twenty years ago, the original Tactical Combat Casualty Care (TCCC) article was published in this journal. Since TCCC is essentially a set of bestpractice prehospital trauma care guidelines customized for use on the battlefield, the presence of a journal with a specific focus on military medicine was a profound benefit to the initial presentation of TCCC to the US Military. METHODS: In the two ensuing decades, which included the longest continuous period of armed conflict in our nation's history, TCCC steadily evolved as the prehospital trauma care evidence base was augmented and as feedback from user medics, corpsmen, and pararescuemen was obtained...
December 0: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28562239/vascular-access-in-pediatric-patients-in-the-emergency-department-types-of-access-indications-and-complications
#17
REVIEW
Rachel Whitney, Melissa Langhan
Vascular access is a potentially life-saving procedure that is a mainstay of emergency medicine practice. There are a number of challenges associated with obtaining and maintaining vascular access, and the choice of the route of access and equipment used will depend on patient- and provider-specific factors. In this issue, the indications and complications of peripheral intravenous access, intraosseous access, and central venous access are reviewed. Timely and effective assessment and management of difficult-access patients, pain control techniques that can assist vascular access, and contraindications to each type of vascular access are also discussed...
June 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28507384/intraosseous-access-over-central-venous-or-peripheral-venous-line-as-an-initial-means-of-resuscitation-a-possible-measure-for-improving-outcomes-of-cardiac-arrests
#18
Saad Ullah, Anas Siddiqui, Noman Ahmed Jang Khan
No abstract text is available yet for this article.
May 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28500463/comparison-of-four-different-intraosseous-access-devices-during-simulated-pediatric-resuscitation-a-randomized-crossover-manikin-trial
#19
Karol Bielski, Lukasz Szarpak, Jacek Smereka, Jerzy R Ladny, Steve Leung, Kurt Ruetzler
The aim of the study was to compare the success rate, procedure time, and user satisfaction of pediatric NIO™ compared to Pediatric BIG®, EZ-IO®, and Jamshidi intraosseous access devices. This was a randomized, crossover manikin trial with 87 paramedics. The correct location of intraosseous access when using NIO, BIG, EZ-IO, and Jamshidi was varied and was respectively 100, 90, 90, and 90%. The time required to obtain intravascular access (time T1) in the case of NIO, BIG, EZ-IO, and Jamshidi was varied and amounted to 9 s [IQR, 8-12] for NIO, 12 s [IQR, 9-16] for BIG, 13...
July 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28499516/improving-cpr-performance
#20
REVIEW
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
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