407: Pain Management During Intraosseous Infusion Through the Proximal Humerus

Philbeck, Thomas; Miller, Laura J.; Montez, Diana

doi:10.1016/j.annemergmed.2009.06.447

Cited by 15 publications

(9 citation statements)

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“…Insertion pain has been reported by several investigators to have a mean visual analog scale score between 2.5 and 3.5, similar to scores associated with peripheral and central device placement. [39][40][41] Infusion pain has also been addressed. In a large, 1128-case series using the powered drill device, the investigators found that, in most cases, patient pain level upon infusion of fluids could be substantially reduced by injecting 0.5 mg/kg of preservative-free lidocaine through the IO port prior to infusion.…”

Section: Other Considerations Pain In the Conscious Patientmentioning

confidence: 99%

Recommendations for the Use of Intraosseous Vascular Access for Emergent and Nonemergent Situations in Various Health Care Settings

Phillips

Proehl

Brown

et al. 2010

Journal of Infusion Nursing

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Section: Other Considerations Pain In the Conscious Patientmentioning

confidence: 99%

Recommendations for the Use of Intraosseous Vascular Access for Emergent and Nonemergent Situations in Various Health Care Settings

Phillips

Proehl

Brown

et al. 2010

Journal of Infusion Nursing

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“…As far as insertion pain is concerned, three studies describe it using the VAS score (1-10) with an average of 3.7 [27][28][29]. 5 studies on the level of pain perceived during infusion, which also used the VAS score (1-10), reported an average value of 5.4 [19,[27][28][29].…”

Section: Complication Ratingmentioning

confidence: 99%

Efficacy and Safety of the Intraosseous Vascular Access in out-of-Hospital Emergencies: A Prospective Study of the Pre-Hospital Emergency Service (SUEM 118) of Padua from 2012 to Today

Paoli¹,

Marco²,

Boscolo³

et al. 2018

Int J Anesthetic Anesthesiol

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Background: Several scientific associations recommend the use of the intraosseous access as a valid alternative to the intravenous route, which is often difficult to find in emergency conditions, as a safe and effective way for drugs and fluids administration and for blood sampling. Aim of the study: The purpose of this study was the evaluation of the use of the EZ-IO ® device, by the S.U.E.M. 118 of Padua, in terms of efficacy and safety in obtaining intraosseous vascular access for fluids and drugs infusions in an out-of-hospital emergency setting. Materials and methods: From February 2012 to May 2016, all cases of pre-hospital IO access within the operational areas of the Pre-hospital Emergency Service (SUEM 118) of Padua were prospectively recorded. Data were collected by using a standardized grid and by consulting the online computer server Galileo. Data were then analysed by using the Statgraphics Centurion and Microsoft ® Excel software. Results: 89 patients required an intraosseous vascular access. Needles' placement using the EZ-IO device was successful in 97.75% (87/89). Considering only first attempts, the success rate is 95.51% (85/89). No immediate complications were observed. After one year, one patient was found to have an abscess at the insertion site, but there are insufficient data to establish the cause. Pain was evaluated in 38 patients, after administration of Lidocaine and the Mean value was calculated to be 3 and standard deviation (sd) 2. Only one patient reported unbearable pain (10/10). Conclusions: The high percentage of successful insertions along with low complication rates, shows that the use of intraosseous vascular access should be considered as first line treatment in out-of-hospital emergencies, whenever a rapid and safe vascular access is required, thus it can be used in every situation where a vascular access is impossible to obtain, regardless of the clinical conditions of the patient and the elapsed time.

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“…In a conscious patient, pain on puncture might become an issue [19][20][21]. The provider must distinguish between local periostal anesthesia and endostal medullary anesthesia.…”

Section: Key Pointsmentioning

confidence: 99%

Intraosseous infusion in elective and emergency pediatric anesthesia

Neuhaus

2014

Current Opinion in Anaesthesiology

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Most problems in using an intraosseous infusion are provider-dependent. In pediatric anesthesia, the perioperative setting should further contribute to reduce these problems. Nevertheless, regular training, thorough anatomical knowledge and prompt availability especially in the pediatric age group are paramount to get a seldom used technique work properly under pressure. More longitudinal data on large cohorts were preferable to further support the safety of the intraosseous infusion technique in pediatric patients.

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407: Pain Management During Intraosseous Infusion Through the Proximal Humerus

Cited by 15 publications

References 0 publications

Recommendations for the Use of Intraosseous Vascular Access for Emergent and Nonemergent Situations in Various Health Care Settings

Recommendations for the Use of Intraosseous Vascular Access for Emergent and Nonemergent Situations in Various Health Care Settings

Efficacy and Safety of the Intraosseous Vascular Access in out-of-Hospital Emergencies: A Prospective Study of the Pre-Hospital Emergency Service (SUEM 118) of Padua from 2012 to Today

Intraosseous infusion in elective and emergency pediatric anesthesia

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