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Intraosseous access

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https://www.readbyqxmd.com/read/27911381/a-novel-approach-for-the-administration-of-medications-and-fluids-in-emergency-scenarios-and-settings
#1
Akilesh Honasoge, Neal Lyons, Kathleen Hesse, Braden Parker, Robert Mokszycki, Kelly Wesselhoff, Rolla Sweis, Erik B Kulstad
The available routes of administration commonly used for medications and fluids in the acute care setting are generally limited to oral, intravenous, or intraosseous routes, but in many patients, particularly in the emergency or critical care settings, these routes are often unavailable or time-consuming to access. A novel device is now available that offers an easy route for administration of medications or fluids via rectal mucosal absorption (also referred to as proctoclysis in the case of fluid administration and subsequent absorption)...
November 9, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/27870553/comparison-of-two-intraosseous-devices-the-nio-versus-the-ez-io-by-novice-users-a-randomized-cross-over-trial
#2
Avi Shina, Erez Nissim Baruch, Amir Shlaifer, Ami Shovali, Moran Levi, Or Yosefy, David Segal, Tarif Bader, Itai Shavit, Avraham Yitzhak
BACKGROUND: During resuscitation in the field, intraosseous (IO) access may be achieved using a variety of available devices, often attempted by inexperienced users. AIM: We sought to examine the success rate and ease-of-use ratings of an IO device, the NIO® (New Intraosseous Persys Medical, Houston, TX, USA) in comparison to the Arrow® EZ-IO® (Teleflex Medical Research Triangle Park, NC, USA) by novice users. METHODS: We performed a randomized crossover trial...
November 21, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27849905/263-adequacy-of-intraosseous-vascular-access-insertion-sites-for-high-volume-fluid-infusion
#3
Tatiana Puga, Diana Montez, Thomas Philbeck, Chris Davlantes
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27849895/253-48-hours-dwell-time-for-intraosseous-access-a-longer-term-infusion-using-a-temporary-solution
#4
Chris Davlantes, Tatiana Puga, Diana Montez, Thomas Philbeck, Larry Miller, Emanuel DeNoia
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27809922/analysis-of-thromboelastography-pt-aptt-and-fibrinogen-in-intraosseous-and-venous-samples-an-experimental-study
#5
Gunnar Strandberg, Miklós Lipcsey, Mats Eriksson, Norbert Lubenow, Anders Larsson
BACKGROUND: Laboratory analysis of coagulation is often important in emergencies. If vascular access is challenging, intraosseous catheterization may be necessary for treatment. We studied the analysis of coagulation parameters in intraosseous aspirate during stable conditions and after major haemorrhage in a porcine model. METHODS: Ten anesthetized pigs received central venous and intraosseous catheters and samples were taken for analysis of thromboelastography (TEG), prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrinogen concentration...
November 3, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27779964/intraosseous-infusion-as-a-bridge-to-definitive-access
#6
Megan Johnson, Kenji Inaba, Saskya Byerly, Erika Falsgraf, Lydia Lam, Elizabeth Benjamin, Aaron Strumwasser, Jean-Stephane David, Demetrios Demetriades
Intraosseous (IO) needle placement is an alternative for patients with difficult venous access. The purpose of this retrospective study was to examine indications and outcomes associated with IO use at a Level 1 trauma center (January 2008-May 2015). Data points included demographics, time to insertion, intravenous (IV) access points, indications, infusions, hospital and intensive care unit length of stay, and mortality. Of 68 patients with IO insertion analyzed (63.2% blunt trauma, 29.4% penetrating trauma, and 7...
October 2016: American Surgeon
https://www.readbyqxmd.com/read/27687698/evaluation-of-intraosseous-sampling-for-measurements-of-alanine-aminotransferase-alkaline-phosphatase-aspartate-aminotransferase-creatinine-kinase-gamma-glutamyl-transferase-and-lactate-dehydrogenase
#7
Mats Eriksson, Gunnar Strandberg, Miklós Lipcsey, Anders Larsson
BACKGROUND: Intraosseous (IO) access can be established faster than a venous or arterial access when there is an urgent need for rapid initiation of treatment. The access can also be used to draw marrow samples. The aim of the present study was to evaluate the potential use of IO samples for enzyme determinations using a porcine model. MATERIALS AND METHODS: Bilateral tibial intraosseous cannulae and an arterial catheter were used for blood sampling from five healthy anesthetized pigs...
December 2016: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/27669404/use-of-intraosseous-devices-in-trauma-a-survey-of-trauma-practitioners-in-canada-australia-and-new-zealand
#8
Paul T Engels, Mete Erdogan, Sandy L Widder, Michael B Butler, Nelofar Kureshi, Kate Martin, Robert S Green
BACKGROUND: Although used primarily in the pediatric population for decades, the use of intraosseous (IO) devices in the resuscitation of severely injured adult trauma patients has recently become more commonplace. The objective of this study was to determine the experience level, beliefs and attitudes of trauma practitioners in Canada, Australia and New Zealand regarding the use of IO devices in adult trauma patients. METHODS: We administered a web-based survey to all members of 4 national trauma and emergency medicine organizations in Canada, Australia and New Zealand...
October 1, 2016: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/27623218/point-of-care-ultrasound-diagnosis-of-intravascular-air-after-lower-extremity-intraosseous-access
#9
Benjamin Azan, Felipe Teran, Bret P Nelson, Phillip Andrus
BACKGROUND: Vascular air embolism is a rare but potentially deadly phenomenon. Early diagnosis allows providers to initiate measures aimed at preventing further air entry, preventing the migration of air to the lungs, and mitigating the hemodynamic effects of pulmonary air embolism. CASE REPORT: An emergency physician used point-of-care ultrasound to identify intravascular air before embolization to the pulmonary vasculature. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Bedside ultrasound can be used as a tool for early diagnosis of intravascular air...
December 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27575561/ultrasound-to-improve-target-site-identification-for-proximal-humerus-intraosseous-vascular-access
#10
Sergio Bustamante, Shravan Cheruku
No abstract text is available yet for this article.
August 29, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27572932/ct-angiography-of-the-chest-and-abdomen-in-an-emergency-patient-via-humeral-intraosseous-access
#11
Nils Markus Budach, Stefan Markus Niehues
A 69-year-old woman was taken to our emergency department after having been found unconscious. An intraosseous catheter was placed in the head of the right humerus due to inaccessible peripheral veins. With the suspected diagnosis of shock, pulmonary embolism, and mesenteric ischemia, a CT scan of the chest and abdomen was initiated. Pulmonary embolism and mesenteric arterial embolism could be ruled out at excellent image quality.
August 29, 2016: Emergency Radiology
https://www.readbyqxmd.com/read/27522216/evidence-on-adrenaline-use-in-resuscitation-and-its-relevance-to-newborn-infants-a-non-systematic-review
#12
Merlin Pinto, Anne Lee Solevåg, Megan OʼReilly, Khalid Aziz, Po-Yin Cheung, Georg M Schmölzer
AIM: Guidelines for newborn resuscitation state that if the heart rate does not increase despite adequate ventilation and chest compressions, adrenaline administration should be considered. However, controversy exists around the safety and effectiveness of adrenaline in newborn resuscitation. The aim of this review was to summarise a selection of the current knowledge about adrenaline during resuscitation and evaluate its relevance to newborn infants. METHODS: A search in PubMed, Embase, and Google Scholar until September 1, 2015, using search terms including adrenaline/epinephrine, cardiopulmonary resuscitation, death, severe brain injury, necrotizing enterocolitis, bronchopulmonary dysplasia, and adrenaline versus vasopressin/placebo...
August 13, 2016: Neonatology
https://www.readbyqxmd.com/read/27494435/adult-intraosseous-access-by-advanced-emts-a-statewide-non-inferiority-study
#13
Daniel L Wolfson, Margaret A Tandoh, Mohit Jindal, Patrick M Forgione, Valerie S Harder
OBJECTIVE: Intraosseous (IO) access is increasingly being used as an alternative to peripheral intravenous access, which is often difficult or impossible to establish in critically ill patients in the prehospital setting. Until recently, only Paramedics performed adult IO access. In 2014, Vermont Emergency Medical Services (EMS) expanded the Advanced Emergency Medical Technicians (AEMTs) scope of practice to include IO access in adult patients. This study compares successful IO access in adults performed by AEMTs compared to Paramedics in the prehospital setting...
August 5, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27479261/-case-report-bilateral-humeral-intraosseous-access-for-cpr-in-a-3-years-old-child
#14
Thorsten Hess, Roman Böhmer, Florian Arndt, Gernot Lorber, Jochen Herrmann, Klaus Püschel, Thoralf Kerner
On-scene invasive emergency procedures, such as intraosseous puncture, are often unavoidable, when indicated, and present a challenge for the emergency physician. Personal, temporal or local conditions are often unsuitable. Even with regular intervention by the emergency medical service, "last resort" measures occur very infrequently, particularly in pediatric emergencies. For the first time, this case report presents the use of intraosseous access at the humeral head with children, with reference to indication, implementation, problems and risks...
July 2016: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/27397758/single-treatment-of-vx-poisoned-guinea-pigs-with-the-phosphotriesterase-mutant-c23al-intraosseous-versus-intravenous-injection
#15
Timo Wille, Katharina Neumaier, Marianne Koller, Christina Ehinger, Nidhi Aggarwal, Yacov Ashani, Moshe Goldsmith, Joel L Sussman, Dan S Tawfik, Horst Thiermann, Franz Worek
The recent attacks with the nerve agent sarin in Syria reveal the necessity of effective countermeasures against highly toxic organophosphorus compounds. Multiple studies provide evidence that a rapid onset of antidotal therapy might be life-saving but current standard antidotal protocols comprising reactivators and competitive muscarinic antagonists show a limited efficacy for several nerve agents. We here set out to test the newly developed phosphotriesterase (PTE) mutant C23AL by intravenous (i.v.), intramuscular (i...
September 6, 2016: Toxicology Letters
https://www.readbyqxmd.com/read/27344097/intraosseous-access-in-the-obese-patient-assessing-the-need-for-extended-needle-length
#16
Thompson Kehrl, Brent A Becker, Dell E Simmons, Erin K Broderick, Robert A Jones
BACKGROUND: Intraosseous (IO) access can be complicated by obesity. Successful placement of a 25 mm IO needle is unlikely when soft tissue depth exceeds 20 mm. OBJECTIVES: The authors examined the relationship between body mass index (BMI), the ability to palpate the tibial tuberosity (TT), and soft tissue depth at recommended IO insertion sites. METHODS: Obese emergency department patients were assessed for a palpable TT and received ultrasound measurement of the soft tissue depth at recommended IO insertion sites...
September 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27296956/sex-differences-in-the-prehospital-management-of-out-of-hospital-cardiac-arrest
#17
Bryn E Mumma, Temur Umarov
BACKGROUND: Sex differences exist in the diagnosis and treatment of several cardiovascular diseases. Our objective was to determine whether sex differences exist in the use of guideline-recommended treatments in out-of-hospital cardiac arrest (OHCA). METHODS: We included adult patients with non-traumatic OHCA treated by emergency medical services (EMS) in the Resuscitation Outcomes Consortium Prehospital Resuscitation using an IMpedance valve and Early versus Delayed (ROC PRIMED) database during 2007-2009...
August 2016: Resuscitation
https://www.readbyqxmd.com/read/27242115/success-of-intraosseous-access-procedure-in-simulated-adult-resuscitation
#18
RANDOMIZED CONTROLLED TRIAL
Piotr Zasko, Lukasz Szarpak, Andrzej Kurowski, Zenon Truszewski, Lukasz Czyzewski
No abstract text is available yet for this article.
June 2016: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/27241639/feasibility-study-of-a-novel-intraosseous-device-in-adult-human-cadavers
#19
Sandeep Singh, Praveen Aggarwal, Rakesh Lodha, Ramesh Agarwal, Arun Kr Gupta, Renu Dhingra, Jayant Sitaram Karve, Srinivas Kiran Jaggu, Balram Bhargava
BACKGROUND & OBJECTIVES: Intraosseous (IO) access is an alternative to difficult intravenous (iv) access during emergency clinical situations. Existing IO solutions are expensive, require power supply and trained manpower; limiting their use in resource constrained settings. To address these limitations, a novel IO device has been developed. The objectives of this study were to evaluate functionality and safety of this device in adult human cadavers. METHODS: The ability of the IO device to penetrate the proximal and/or distal tibia was evaluated in three adult cadavers...
March 2016: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/27241636/challenges-in-the-use-of-intraosseous-access
#20
Peter Hallas
No abstract text is available yet for this article.
March 2016: Indian Journal of Medical Research
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