Intraosseous puncture in preclinical emergency medicine

Helm, Matthias; Hauke, J.; Bippus, N.; Lampl, L.

doi:10.1007/s00101-006-1124-2

Cited by 30 publications

(8 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although the EMS paramedics are trained in intraosseous access, it is not widely applied: only 31% of all intraosseous access was provided by the EMS paramedics. The infrequent use of intraosseous infusion compared to other advanced life support skills in hospital and by paramedics and HEMS has been described [12,13]. Still, several studies have shown that the placement of an intraosseous line is easy, fast and has a high success rate [14-16].…”

Section: Discussionmentioning

confidence: 99%

Advanced medical life support procedures in vitally compromised children by a helicopter emergency medical service

et al. 2010

View full text Add to dashboard Cite

BackgroundTo determine the advanced life support procedures provided by an Emergency Medical Service (EMS) and a Helicopter Emergency Medical Service (HEMS) for vitally compromised children. Incidence and success rate of several procedures were studied, with a distinction made between procedures restricted to the HEMS-physician and procedures for which the HEMS is more experienced than the EMS.MethodsProspective study of a consecutive group of children examined and treated by the HEMS of the eastern region of the Netherlands. Data regarding type of emergency, physiological parameters, NACA scores, treatment, and 24-hour survival were collected and subsequently analysed.ResultsOf the 558 children examined and treated by the HEMS on scene, 79% had a NACA score of IV-VII. 65% of the children had one or more advanced life support procedures restricted to the HEMS and 78% of the children had one or more procedures for which the HEMS is more experienced than the EMS. The HEMS intubated 38% of all children, and 23% of the children intubated and ventilated by the EMS needed emergency correction because of potentially lethal complications. The HEMS provided the greater part of intraosseous access, as the EMS paramedics almost exclusively reserved this procedure for children in cardiopulmonary resuscitation. The EMS provided pain management only to children older than four years of age, but a larger group was in need of analgesia upon arrival of the HEMS, and was subsequently treated by the HEMS.ConclusionsThe Helicopter Emergency Medical Service of the eastern region of the Netherlands brings essential medical expertise in the field not provided by the emergency medical service. The Emergency Medical Service does not provide a significant quantity of procedures obviously needed by the paediatric patient.

show abstract

Section: Discussionmentioning

confidence: 99%

Advanced medical life support procedures in vitally compromised children by a helicopter emergency medical service

et al. 2010

View full text Add to dashboard Cite

show abstract

“…Zum anderen bestehen Unterschiede zwischen dem bodengebundenen und luftgestütz-ten Rettungsdienst: Für bodengebundene Notarztsysteme wird die Häufigkeit päd-iatrischer Notfallsituationen mit etwa 3-6% angegeben, für den luftgestützten Rettungsdienst mit rund 11-13% [9,10,12,16,18,25]. In diesem Zusammenhang ist insbesondere eine multizentrische Studie, die Daten sämtlicher Luftrettungsstütz-punkte des ADAC sowie des Bundesinnenministeriums beinhaltet und somit einen annähernd bundesweiten Überblick erlaubt, erwähnenswert [25]: Der Anteil pädiatrischer Notfälle lag in dieser Untersuchung bei 12,9% (Erfassungszeitraum 2001 bis 2003).…”

Section: Häufigkeit Pädiatrischer Notfälleunclassified

“…Zudem zeigt ein Vergleich mit vorangegangenen Analysen der RTH-Station "Christoph 22" aus den Zeiträumen von 1993 bis 1997 und 1996 bis 2005, dass der Anteil an "traumatologischen" Notfällen stabil geblieben ist (61 bzw. 54%; [16,18]). Unter Berücksichtigung der verschiedenen Altersgruppen spielt der traumatologische Notfall bei Säuglingen eine untergeordnete Rolle.…”

Section: Einsatzspektrumunclassified

“…schwer verletzte Mit nahezu 80% liegt die Häufigkeit des Gefäßzugangs bei allen pädiatrischen Notfallpatienten in der vorgestellten Studie im oberen Bereich dessen, was diesbezüglich in der Literatur für den Luftrettungsdienst angegeben wird [1,25]. Interessanterweise war insgesamt keine Zunahme der Zahl an intraossären Punktionen als Alternative zum periphervenösen Zugang im Vergleich zu vorausgegangenen Beobachtungszeiträumen zu verzeichnen (2,5 aktuell vs. 2,6% im Beobachtungszeitraum von 1996 bis 2005; [16]). Auch zeigt die differenzierte Betrachtung unter Berücksichtigung der Altersgruppen, dass die intraossäre Punktion nach wie vor mit nahezu 90% bei Kindern im Alter jünger als 6 Jahre und damit über-wiegend bei der von verschiedenen Fachgesellschaften empfohlenen "klassischen" Zielgruppe angewendet wurde [6,15,17,20].…”

Section: Erkrankungs-und Verletzungsschwereunclassified

See 1 more Smart Citation

Pädiatrischer Notfallpatient im Luftrettungsdienst

et al. 2010

Self Cite

View full text Add to dashboard Cite

Compared to the results of other studies the number of pediatric emergency patients with a NACA score IV-VII in this study is very high. Furthermore, the percentages of non-invasive monitoring procedures applied to the patients as well as invasive therapeutic procedures performed by the HEMS team were also high. Therefore, a special pediatric training course for emergency physicians seems to be necessary.

show abstract

“…Die intraossäre Infusionstechnik hat sich in der pädiatrischen Notfallmedi zin seit Jahren als schnelle, effiziente und sichere Alternativmethode zur Schaffung eines Gefäßzugangs erwiesen, um einem vitalgefährdeten Kind dringend benöti gte Medikamente und Flüssigkeiten zu ap plizieren [21,51].…”

Section: Grundlagenunclassified

Intraossäre Infusion

et al. 2009

View full text Add to dashboard Cite

Timely establishment of venous access in infants and toddlers can prove a particularly challenging task. Since the 1940s the technique of intraosseous infusion has established itself as a valuable alternative means for rapid, efficient and safe delivery of drugs and fluids to critically ill children. Whereas international guidelines for paediatric emergency medical care have assigned intraosseous infusion a high priority, most anaesthetists utilize this well-proven technique with great reluctance. This article describes the technique of intraosseous infusion, introduces two different cannulation systems, and discusses its potential indications in paediatric anaesthesia, based on current emergency medical care guidelines as well as some of our own case studies. In particular, children with acutely life-threatening conditions, such as circulatory arrest, laryngospasm, acute airway haemorrhage, hypovolaemic shock or hypothermia secondary to extensive burns, should receive an intraosseous cannula if intravenous access cannot be rapidly established. Future discussion may reveal whether a transiently inserted intraosseous infusion would also be indicated if the child with difficult or impossible venous access presents without acute life-threatening conditions for anaesthesia. Successful application of the intraosseous infusion technique requires immediate access to the necessary equipment, intensive education, continuous training and clear guidelines for its application in an anaesthesia department.

show abstract

Intraosseous puncture in preclinical emergency medicine

Abstract: The IO infusion technique is a simple, fast and safe alternative method for emergency access to the vascular system in children < or =6 years of age in the prehospital setting.

Cited by 30 publications

References 27 publications

Advanced medical life support procedures in vitally compromised children by a helicopter emergency medical service

Advanced medical life support procedures in vitally compromised children by a helicopter emergency medical service

Pädiatrischer Notfallpatient im Luftrettungsdienst

Intraossäre Infusion

Contact Info

Product

Resources

About