Intraosseous access in the setting of pediatric critical care transport

Fiorito, Brad A.; Mirza, Farrukh; Doran, Theresa M.; Oberle, Anita N.; Cruz, Eleanor C. Vince; Wendtland, Cherry L.; Abd-Allah, Shamel

doi:10.1097/01.pcc.0000149137.96577.a6

Cited by 74 publications

(46 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Obtaining peripheral venous access can be challenging in infants and children during an emergency; intraosseous (IO) access can be quickly established with minimal complications by providers with varied levels of training. [172][173][174][175][176][177][178][179] Limit the time spent attempting to establish peripheral venous access in a critically ill or injured child. 180…”

Section: Vascular Accessmentioning

confidence: 99%

“…IO access is a rapid, safe, effective, and acceptable route for vascular access in children, [172][173][174][175][176][177][178][179]181 and it is useful as the initial vascular access in cases of cardiac arrest (Class I, LOE C). All intravenous medications can be administered intraosseously, including epinephrine, adenosine, fluids, blood products, 182,183 and catecholamines.…”

Section: Intraosseous (Io) Accessmentioning

confidence: 99%

See 1 more Smart Citation

Part 14: Pediatric Advanced Life Support

Kleinman¹,

Chameides²,

Schexnayder³

et al. 2010

Circulation

915

304

View full text Add to dashboard Cite

Section: Vascular Accessmentioning

confidence: 99%

Section: Intraosseous (Io) Accessmentioning

confidence: 99%

Part 14: Pediatric Advanced Life Support

Kleinman¹,

Chameides²,

Schexnayder³

et al. 2010

Circulation

915

304

View full text Add to dashboard Cite

“…One final recommendation was that community physicians should intervene with early vascular access, either by peripheral, IO, or central venous route, and administer aggressive fluid resuscitation until resolution of shock symptoms. Out-ofhospital pediatric cardiac arrests generally have poor outcomes, but it is known that children arriving to the emergency department asystolic fare worse (12)(13)(14). The ability to more rapidly deliver resuscitation fluids and medicines via the IO route could possibly improve outcomes in these patients.…”

Section: Discussionmentioning

confidence: 99%

“…It has been well described that early initiation and aggressive fluid resuscitation improve outcomes in sepsis (14). One final recommendation was that community physicians should intervene with early vascular access, either by peripheral, IO, or central venous route, and administer aggressive fluid resuscitation until resolution of shock symptoms.…”

Section: Discussionmentioning

confidence: 99%

A life-saving line in resuscitation and shock management of the critically ill child: intraosseous infusion Kritik olarak hasta olan çocuğun canlandırılması ve şok tedavisindeyaşam kurtarıcı bir yol:

Kendirli¹

2005

Ankara Üniversitesi Tıp Fakültesi Mecmuası

View full text Add to dashboard Cite

Aim: Intraosseous infusion (IOI) is an alternative method of vascular access which is considered when peripheral intravenous line cannot be achieved rapidly. Epinephrine, adenosine, crystalloids, colloids and blood products can be administered effectively using this route during resuscitation and shock management. Material and Methods:We retrospectively evaluated the medical records of Pediatric Intensive Care Unit (PICU) patients who had required IOI administration, and the complications of this method are searched. Results: Medical records of 332 patients who had been followed in our PICU were examined and 13 patients (3.9%) were detected to have IOI administered. Our patients' median age was 8 months, and male:female ratio was 2,5. The primary diagnoses of our IOI administered patients were septic shock (6), cardiogenic shock (2), acute gastroenteritis (1), hemorrhagic shock and encephalopathy syndrome (4). IOI were performed 2 of 13 patients during resuscitation. We performed IOI by spinal needle in 10 (76.9%) patients and by bone marrow aspiration needle in three patients. Eight (61.64%) patients were inpatient. The sites for placement of IO line were right proximal tibia in 12 patients, left proximal tibia in 2 patients, and right distal femur in one patient. The median time of IOI was 20 hours (3 hours-9 days) , and 11 patients survived in the first 24 hours. The only complication was extravasation, seen in a patient. Conclusion: IOI is indicated in life-threatening situations in which vascular access is essential for treatment, and should be kept in mind for being an easily achieved vascular access.Key words: intraosseous infusion, shock, resuscitation, emergency treatment Amaç: Kemik içi (Kİ) infüzyon acil durumlarda damaryolu açılamadığında ilâç ve sıvı tedavisi için alternatif bir yoldur. Bu yolla canlandırma sırasında ve şokta epinefrin, adenozin, kristaloid, kolloid ve kan ürünleri etkin bir şekilde uygulanabilir. Gereç ve Yöntem: Yoğun bakım ünitesinde yatmış ve Kİ infüzyon tedavisi uygulanmış olan hastaların dosyaları retrospektif olarak incelenerek, bu tedavinin yapıldığı hastalar ve komplikasyonlar değerlendirildi. Bulgular: Yoğun bakım ünitemizde yatan 332 hastadan 13 (3.9%)'üne Kİ infüzyon tedavisi uygulandı. Hastalarımızda median yaş 8 ay, erkek kız oranı 2.5 bulundu. Kİ infüzyon tedavisi uygulanan hastaların tanıları septik şok (6), kardiyojenik şok (2), akut gastroenterit (1), hemorajik şok ve ensefalopati sendromu (4) idi. Kİ infüzyonu 13 hastadan 2'sine canlandırma sırasında uygulandı. On (76.9%) hastaya spinal iğne, 3 hastaya ise kemik iliği aspirasyon iğnesi ile Kİ infüzyonu yapıldı. Sekiz (61.64%) hasta daha önceden hastanede yatmaktaydı. Kemik içi infüzyon tedavisi 12 hastada sağ proksimal tibia, 2 hastada sol proksimal tibia ve bir hastada sağ distal femurdan uygulandı. Kemik içi uygulanan iğneler ortalama 20 saat (3 saat-9 gün) kaldı ve 11 hasta 24 saatten uzun süre yaşadı. Hastalardan sadece birisinde 1 kez görülen ilâç ekstravazasyonu, tek komplikasyon idi. Sonuç: Kemik içi infüzy...

show abstract

“…20 Another pediatric critical care transport study noted a requirement of 1.2 intraosseous vascular attempts per patient, with a first attempt success rate of 78%. 21 Finally, the wearing of chemical warfare protective garments by rescuers has been shown to increase the requirement for second attempts at intraosseous access with the bone injection gun. 22 …”

Section: Success Ratesmentioning

confidence: 99%