Intraosseous vascular access in adults using the EZ-IO in an emergency department

被引:47
作者
Ngo A.S.-Y. [1 ,3 ,4 ]
Oh J.J. [1 ]
Chen Y. [2 ]
Yong D. [1 ]
Ong M.E.H. [1 ,3 ,4 ]
机构
[1] Department of Emergency Medicine, Singapore General Hospital, Singapore 169608, Outram Road
[2] Singapore Clinical Research Institute, Singapore
[3] School of Medicine, National University of Singapore
关键词
Infusion rates; Intraosseous needle; Intravenous access;
D O I
10.1007/s12245-009-0116-9
中图分类号
学科分类号
摘要
Background: Intraosseous (IO) access is an alternative to conventional intravenous access. Aims: We evaluate the use of the EZ-IO™ as an alternative vascular access for patients in the emergency department. Methods: A non-randomized, prospective, observational study was performed in adults using the EZ-IO™ powered drill device. Results Twenty-four patients were recruited. There were 35 intraosseous insertions, including 24 tibial and 11 humeral insertions. All EZ-IO™ insertions were achieved within 20 s and were successful at the first attempt except for one. Of the intraosseous insertions, 88.6% were reported to be easier than intravenous cannulation. We found flow rates to be significantly faster using a pressure bag. The seniority of operators did not affect the success of insertion. Complications included a glove being caught in the drill device and extravasation of fluid although they were easily preventable. Conclusion: The use of the EZ-IO™ provides a fast, easy and reliable alternative mode of venous access, especially in the resuscitation of patients with no venous vascular access in the emergency department. Flow rates may be improved by the use of pressure bags. © Springer-Verlag London Ltd 2009.
引用
收藏
页码:155 / 160
页数:5
相关论文
共 40 条
[1]  
Drinker C.K., Drinker K.R., Lund C.C., The circulation in the mammalian bone marrow, Am J Physiol, 62, pp. 1-92, (1922)
[2]  
Morrison G.M., The initial care of casualties, Am Pract, 1, pp. 183-184, (1946)
[3]  
Boon J.M., Gorry D.L., Meiring J.H., Finding an ideal site for intraosseous infusion of the tibia: An anatomical study, Clin Anat, 16, pp. 15-18, (2003)
[4]  
Frascone R.J., Jensen J.P., Kaye K., Salzman J.G., Consecutive field trials using two different intraosseous devices, Prehospital Emergency Care, 11, 2, pp. 164-171, (2007)
[5]  
Mattera C.J., Take aim-hit your IO target. A comprehensive approach to pediatric intraosseous infusion, including site selection, needle insertion & ongoing assessment, Part 2. JEMS, 25, pp. 38-48, (2000)
[6]  
Cilley R.E., Intraosseous infusion in infants and children, Semin Pediatr Surg, 1, pp. 202-207, (1992)
[7]  
Helm M., Hauke J., Bippus N., Lampl L., Intraosseous puncture in preclinical emergency medicine. Ten years experience in air rescue service (in German), Anaesthesist, 56, pp. 18-24, (2007)
[8]  
Jaimovich D.G., Kecskes S., Intraosseous infusion: A rediscovered procedure as an alternative for pediatric vascular access, Indian J Pediatr, 58, pp. 329-334, (1991)
[9]  
Seigier R.S., Tecklenburg F.W., Shealy R., Prehospital intraosseous infusion by emergency medical services personnel: A prospective study, Pediatrics, 84, pp. 173-177, (1989)
[10]  
Velasco A.L., Delgado-Paredes C., Templeton J., Steigman C.K., Templeton Jr. J.M., Intraosseous infusion of fluids in the initial management of hypovolemic shock in young subjects, J Pediatr Surg, 26, pp. 4-8, (1991)