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Intraosseous access

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https://www.readbyqxmd.com/read/28290925/two-decades-of-saving-lives-on-the-battlefield-tactical-combat-casualty-care-turns-20
#1
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 best-practice 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 U.S. 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...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28288774/intravenous-vs-intraosseous-access-and-return-of-spontaneous-circulation-during-out-of-hospital-cardiac-arrest
#2
Brian Clemency, Kaori Tanaka, Paul May, Johanna Innes, Sara Zagroba, Jacqueline Blaszak, David Hostler, Derek Cooney, Kevin McGee, Heather Lindstrom
INTRODUCTION: Guidelines endorse intravenous (IV) and intraosseous (IO) medication administration for cardiac arrest treatment. Limited clinical evidence supports this recommendation. A multiagency, retrospective study was performed to determine the association between parenteral access type and return of spontaneous circulation (ROSC) in out of hospital cardiac arrest. METHODS: This was a structured, retrospective chart review of emergency medical services (EMS) records from three agencies...
February 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28270248/the-resuscitative-and-pharmacokinetic-effects-of-humeral-intraosseous-vasopressin-in-a-swine-model-of-ventricular-fibrillation
#3
James M Burgert, Arthur D Johnson, Jose Garcia-Blanco, Lawrence V Fulton, Michael J Loughren
Introduction The American Heart Association (AHA; Dallas, Texas USA) and European Resuscitation Council (Niel, Belgium) cardiac arrest (CA) guidelines recommend the intraosseous (IO) route when intravenous (IV) access cannot be obtained. Vasopressin has been used as an alternative to epinephrine to treat ventricular fibrillation (VF). Hypothesis/Problem Limited data exist on the pharmacokinetics and resuscitative effects of vasopressin administered by the humeral IO (HIO) route for treatment of VF. The purpose of this study was to evaluate the effects of HIO and IV vasopressin, on the occurrence, odds, and time of return of spontaneous circulation (ROSC) and pharmacokinetic measures in a swine model of VF...
March 8, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28253870/intraosseous-access-can-be-taught-to-medical-students-using-the-four-step-approach
#4
Monika Afzali, Ask Daffy Kvisselgaard, Tobias Stenbjerg Lyngeraa, Sandra Viggers
BACKGROUND: The intraosseous (IO) access is an alternative route for vascular access when peripheral intravascular catheterization cannot be obtained. In Denmark the IO access is reported as infrequently trained and used. The aim of this pilot study was to investigate if medical students can obtain competencies in IO access when taught by a modified Walker and Peyton's four-step approach. METHODS: Nineteen students attended a human cadaver course in emergency procedures...
March 2, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28249956/long-term-follow-up-of-two-patients-with-retained-intraosseous-sternal-needles
#5
James M Hodgetts, A Johnston, J Kendrew
Sternal intraosseous devices are widely used in both civilian and military trauma when vascular access is difficult to establish. We discuss a rare complication of intraosseous needle insertion in two patients where the needle tip remained in the sternum after the device had been removed. Neither patient had evidence of any complication of the retained intraosseous needle tip after >6 years of follow-up.
March 1, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28203508/deltoid-compartment-syndrome-a-rare-complication-after-humeral-intraosseous-access
#6
Kishan M Thadikonda, Francesco M Egro, Irene Ma, Alexander M Spiess
We present a case of a 65-year-old woman who developed a delayed deltoid compartment syndrome after resuscitation via humeral intraosseous access. Initially she was treated conservatively but then was taken emergently for a fasciotomy. After confirming the diagnosis with compartment pressures, a 2-incision approach was employed and a large hematoma was evacuated from the inferior margin of the anterior deltoid. The rest of the deltoid was inspected and debrided to healthy bleeding tissue. Her fasciotomy wounds were left open to heal on their own due to her tenuous clinical condition...
January 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28140442/the-effects-of-sternal-intraosseous-and-intravenous-administration-of-amiodarone-in-a-hypovolemic-swine-cardiac-arrest-model
#7
Samuel Smith, Bradley Borgkvist, Teara Kist, Jason Annelin, Don Johnson, Robert Long
OBJECTIVE: This study compared the effects of amiodarone via sternal intraosseous (SIO) and intravenous (IV) routes on return of spontaneous circulation (ROSC), time to ROSC, concentration maximum (Cmax), time to maximum concentration (Tmax), and mean concentrations over time in a hypovolemic cardiac arrest model. DESIGN: Prospective, between subjects, randomized experimental design. SETTING: TriService Research Facility. SUBJECTS: Yorkshire-cross swine (n = 28)...
October 2016: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/28140441/effects-of-humerus-intraosseous-versus-intravenous-amiodarone-administration-in-a-hypovolemic-porcine-model
#8
Cpt Monica M Holloway, Cpt Shannan L Jurina, Cpt Joshua D Orszag, Lt George R Bragdon, Lt Rustin D Green, Jose C Garcia-Blanco, Brian E Benham, Ltc Timothy S Adams, Don Johnson
OBJECTIVE: To compare the effects of amiodarone administration by humerus intraosseous (HIO) and intravenous (IV) routes on return of spontaneous circulation (ROSC), time to maximum concentration (Tmax), maximum plasma drug concentration (Cmax), time to ROSC, and mean concentrations over time in a hypovolemic cardiac arrest model. DESIGN: Prospective, between subjects, randomized experimental design. SETTING: TriService Research Facility. SUBJECTS: Yorkshire-cross swine (n = 28)...
October 2016: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/28140440/the-effects-of-tibial-intraosseous-versus-intravenous-amiodarone-administration-in-a-hypovolemic-cardiac-arrest-procine-model
#9
Kathryn Hampton, Eric Wang, Jerome Ivan Argame, Tom Bateman, William Craig, Don Johnson
OBJECTIVE: This study compared the effects of amiodarone via tibial intraosseous (TIO) and intravenous (IV) routes on return of spontaneous circulation (ROSC), time to ROSC, maximum drug concentration (Cmax), time to maximum concentration (Tmax), and mean concentrations over time in a hypovolemic cardiac arrest model. DESIGN: Prospective, between subjects, randomized experimental design. SETTING: TriService Research Facility. SUBJECTS: Yorkshire-cross swine (n = 28)...
October 2016: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/28140439/effects-of-tibial-and-humerus-intraosseous-administration-of-epinephrine-in-a-cardiac-arrest-swine-model
#10
Ltc Denise Beaumont, Asal Baragchizadeh, Charles Johnson, Don Johnson
OBJECTIVE: Compare maximum concentration (Cmax), time to maximum concentration (Tmax), mean serum concentration of epinephrine, return of spontaneous circulation (ROSC), time to ROSC, and odds of survival relative to epinephrine administration by humerus intraosseous (HIO), tibial intraosseous (TIO), and intravenous (IV) routes in a swine cardiac arrest model. DESIGN: Prospective, between subjects, randomized experimental design. SETTING: TriService Research Facility...
October 2016: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/28140438/the-comparison-of-humeral-intraosseous-and-intravenous-administration-of-vasopressin-on-return-of-spontaneous-circulation-and-pharmacokinetics-in-a-hypovolemic-cardiac-arrest-swine-model
#11
Mark H Wimmer, Kenneth Heffner, Michael Smithers, Richard Culley, Jennifer Coyner, Michael Loughren, Don Johnson
INTRODUCTION: The American Heart Association (AHA) recommends intravenous (IV) or intraosseous (IO) vasopressin in Advanced Cardiac Life Support (ACLS). Obtaining IV access in hypovolemic cardiac arrest patients can be difficult, and IO access is often obtained in these life threatening situations. No studies have been conducted to determine the effects of humeral IO (HIO) access with vasopressin in the return of spontaneous circulation (ROSC). Our study compared the kinetics of vasopressin and ROSC with HIO with IV access in the hypovolemic swine model...
October 2016: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/28140436/en-route-intraosseous-access-performed-in-the-combat-setting
#12
Shelia Savell, Alejandra G Mora, Crystal A Perez, Vikhyat S Bebarta, Maj Joseph K Maddry
OBJECTIVE: To describe and compare vascular access practices used by en route care providers during medical evacuation (MEDEVAC). DESIGN: This was a retrospective cohort study. Medical records of US military personnel injured in combat and transported by MEDEVAC teams were queried. PATIENTS: The subjects were transported by military en route care providers, in the combat theater during Operation Enduring Freedom (OEF) between January 2011 and March 2014...
October 2016: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/28102532/time-to-epinephrine-in-out-of-hospital-cardiac-arrest-a-retrospective-analysis-of-intraosseous-versus-intravenous-access
#13
Elliot M Ross, Julian Mapp, Chetan Kharod, David A Wampler, Christopher Velasquez, David A Miramontes
INTRODUCTION: The 2015 advanced cardiac life support update continues to advocate administering epinephrine during cardiac arrest. The goal of our study is to determine if prehospital intraosseous (IO) access results in shorter time to epinephrine than prehospital peripheral intravenous (PIV) access. METHODS: The out-of-hospital cardiac arrest (OHCA) database of a large, urban, fire-based emergency medical services system was searched for consecutive cases of OHCA between January 2013 and December 2015...
April 2016: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/28045841/a-novel-method-of-intraosseous-infusion-of-adenosine-for-the-treatment-of-supraventricular-tachycardia-in-an-infant
#14
Krista Helleman, Amrit Kirpalani, Rodrick Lim
Supraventricular tachycardia is a common arrhythmia faced by emergency physicians in the pediatric population. In most cases, antecubital intravenous access can be established, and adenosine can be administered in a rapid and timely fashion. The role and administration of intraosseous adenosine are poorly established. We describe a case where the administration of adenosine was successful via a mixed method administration.
January 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28018682/bent-metal-in-a-bone-a-rare-complication-of-an-emergent-procedure-or-a-deficiency-in-skill-set
#15
Mridula Krishnan, Katherine Lester, Amber Johnson, Kaye Bardeloza, Peter Edemekong, Ilya Berim
Intraosseous (IO) access is an important consideration in patients with difficult intravenous (IV) access in emergent situations. IO access in adults has become more popular due to the ease of placement and high success rates. The most common sites of access include the proximal tibia and the humeral head. The complications associated are rare but can be catastrophic: subsequent amputation of a limb has been described in the literature. We report a 25-year-old female presenting with diabetic ketoacidosis (DKA) in whom emergent IO access was complicated by needle bending inside the humerus...
2016: Case Reports in Critical Care
https://www.readbyqxmd.com/read/27998615/analysis-of-intraosseous-blood-samples-using-an-epoc-point-of-care-analyzer-during-resuscitation
#16
Crystal Ives Tallman, Michael Darracq, Megann Young
BACKGROUND: In the early phases of resuscitation in a critically ill patient, especially those in cardiac arrest, intravenous (IV) access can be difficult to obtain. Intraosseous (IO) access is often used in these critical situations to allow medication administration. When no IV access is available, it is difficult to obtain blood for point of care analysis, yet this information can be crucial in directing the resuscitation. We hypothesized that IO samples may be used with a point of care device to obtain useful information when seconds really do matter...
December 12, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27984298/knowledge-skills-and-attitudes-concerning-intraosseous-access-among-hospital-physicians
#17
Lukasz Iskrzycki, Jacek Smereka, Lukasz Szarpak
No abstract text is available yet for this article.
January 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/27968755/alternative-access-routes-for-fluid-resuscitation
#18
REVIEW
Tami Lind
Fluid resuscitation in small animals is important in emergency situations and is utilized by every veterinary practice. Peripherally inserted intravenous catheters are an effective way of giving fluids to a veterinary patient. If an intravenous catheter is not obtainable, there are multiple other ways to administer fluids to a patient including dorsal pedal catheters, intraosseous catheters, central venous catheters, peripherally inserted central catheters, nasogastric tubes, nasoesophageal tubes and subcutaneous administration of fluids...
June 2016: Topics in Companion Animal Medicine
https://www.readbyqxmd.com/read/27958767/effect-of-a-connective-tissue-graft-in-combination-with-single-flap-approach-in-the-regenerative-treatment-of-intraosseous-defects
#19
Leonardo Trombelli, Anna Simonelli, Luigi Minenna, Giulio Rasperini, Roberto Farina
BACKGROUND: In the attempt to limit the post-surgery increase in buccal gingival recession (bREC), the effect of a connective tissue graft (CTG) when combined with a buccal Single Flap Approach (SFA) in the regenerative treatment of intraosseous defects was evaluated. METHODS: Data related to 30 patients with an intraosseous defect treated with buccal SFA with (SFA+CTG group; n= 15) or without (SFA group; n= 15) the placement of a CTG and regenerative treatment were retrospectively derived at three clinical centers...
December 13, 2016: Journal of Periodontology
https://www.readbyqxmd.com/read/27911381/a-novel-approach-for-the-administration-of-medications-and-fluids-in-emergency-scenarios-and-settings
#20
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
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