Effectiveness of intraosseous access during resuscitation: a retrospective cohort study.

IF 2.3 3区 医学 Q1 EMERGENCY MEDICINE
Tim W H Rijnhout, Marin Kieft, Willemijn M Klein, Edward C T H Tan
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引用次数: 0

Abstract

Purpose: During resuscitation in emergency situations, establishing intravascular access is crucial for promptly initiating delivery of fluids, blood, blood products, and medications. In cases of emergency, when intravenous (IV) access proves unsuccessful, intraosseous (IO) access serves as a viable alternative. However, there is a notable lack of information concerning the frequency and efficacy of IO access in acute care settings. This study aims to assess the efficacy of intraosseous (IO) access in acute care settings, especially focusing on children in a level 1 trauma center.

Methods: This retrospective study included patients with IO access presented in a level 1 trauma center emergency department (ED) between January 2015 and April 2020. Data regarding medication and fluid infusion was documented, and the clinical success rate was calculated.

Results: Of the 109,548 patients that were admitted to the ED, 25,686 IV lines were inserted. Documentation of 188 patients of which 73 (38.8%) children was complete and used for analysis. In these 188 patients, a total of 232 IO accesses were placed. Overall, 182 patients had a functional IO access (204 needles) (88%). In children (age < 18 years) success rate was lower as compared to adults, 71-84% as compared to 94%. However, univariate regression showed no association between the percentage of functional IO access and gender, age, weight, health care location (prehospital and in hospital), anatomical position (tibia as compared to humerus) or type of injury.

Conclusion: Intraosseous access demonstrates a high success rate for infusion, independent of gender, age, weight, anatomical positioning, or healthcare setting, with minimal complication rates. Caution is especially warranted for children under the age of six months, since success rate was lower.

复苏过程中骨内通路的有效性:一项回顾性队列研究。
目的:在紧急情况下进行复苏时,建立血管内通路对于及时开始输液、输血、输血产品和药物至关重要。在紧急情况下,当静脉(IV)通路不成功时,骨内(IO)通路是一种可行的替代方法。然而,在急诊护理环境中,有关 IO 入路的频率和有效性的信息明显不足。本研究旨在评估在急症护理环境中进行骨内穿刺(IO)的效果,尤其是针对一级创伤中心的儿童:这项回顾性研究纳入了 2015 年 1 月至 2020 年 4 月期间在一级创伤中心急诊科(ED)就诊的 IO 入路患者。研究记录了药物和液体输注的相关数据,并计算了临床成功率:在急诊科收治的 109,548 名患者中,有 25,686 人接受了静脉输液。有 188 名患者的文件记录完整,其中 73 名(38.8%)为儿童,并用于分析。在这 188 名患者中,共安置了 232 个输液通路。总体而言,182 名患者的输液通路功能正常(204 根针)(88%)。在儿童(年龄无论性别、年龄、体重、解剖位置或医疗环境如何,鞘内通路的输液成功率都很高,而且并发症发生率极低。由于成功率较低,6 个月以下的儿童尤其需要谨慎。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMC Emergency Medicine
BMC Emergency Medicine Medicine-Emergency Medicine
CiteScore
3.50
自引率
8.00%
发文量
178
审稿时长
29 weeks
期刊介绍: BMC Emergency Medicine is an open access, peer-reviewed journal that considers articles on all urgent and emergency aspects of medicine, in both practice and basic research. In addition, the journal covers aspects of disaster medicine and medicine in special locations, such as conflict areas and military medicine, together with articles concerning healthcare services in the emergency departments.
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