Intravascular access in pediatric cardiac arrest

Brunette, Douglas D.; Fischer, Robin

doi:10.1016/0735-6757(88)90094-0

Cited by 45 publications

(11 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It can be challenging to obtain vascular access, especially in the resuscitation of small children in emergency situations [3-5]. The European Resuscitation Council 2005 guidelines [6] and International Liaison Committee on Resuscitation guidelines [4] recommend intraosseous access during resuscitation if intravenous access proves to be difficult or impossible.…”

Section: Introductionmentioning

confidence: 99%

“…Intravenous access is traditionally regarded as the optimal route for medication and fluids, and the intraosseous route is often described as the best alternative choice [3,4,11]. Endotracheal, umbilical or intracardial routes are poorer alternatives as regards speed of insertion and reliability in emergency resuscitation.…”

Section: Introductionmentioning

confidence: 99%

“…Endotracheal, umbilical or intracardial routes are poorer alternatives as regards speed of insertion and reliability in emergency resuscitation. Great saphenous vein cutdown as an emergency surgical approach has also been replaced by the faster IO technique [3,12]. In newborn resuscitation, umbilical venous access is often preferred, with intraosseous as an alternative route [12,13].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Emergency intraosseous access in a helicopter emergency medical service: a retrospective study

Sunde

Heradstveit

Vikenes

et al. 2010

Scand J Trauma Resusc Emerg Med

View full text Add to dashboard Cite

BackgroundIntraosseous access (IO) is a method for providing vascular access in out-of-hospital resuscitation of critically ill and injured patients when traditional intravenous access is difficult or impossible. Different intraosseous techniques have been used by our Helicopter Emergency Medical Services (HEMS) since 2003. Few articles document IO use by HEMS physicians. The aim of this study was to evaluate the use of intraosseous access in pre-hospital emergency situations handled by our HEMS.MethodsWe reviewed all medical records from the period May 2003 to April 2010, and compared three different techniques: Bone Injection Gun (B.I.G® - Waismed), manual bone marrow aspiration needle (Inter V - Medical Device Technologies) and EZ-IO® (Vidacare), used on both adults and paediatric patients.ResultsDuring this seven-year period, 78 insertion attempts were made on 70 patients. Overall success rates were 50% using the manual needle, 55% using the Bone Injection Gun, and 96% using the EZ-IO®. Rates of success on first attempt were significantly higher using the EZ-IO® compared to the manual needle/Bone Injection Gun (p < 0.01/p < 0.001). Fifteen failures were due to insertion-related problems (19.2%), with four technical problems (5.1%) and three extravasations (3.8%) being the most frequent causes. Intraosseous access was primarily used in connection with 53 patients in cardiac arrest (75.7%), including traumatic arrest, drowning and SIDS. Other diagnoses were seven patients with multi-trauma (10.0%), five with seizures/epilepsy (7.1%), three with respiratory failure (4.3%) and two others (2.9%). Nearly one third of all insertions (n = 22) were made in patients younger than two years. No cases of osteomyelitis or other serious complications were documented on the follow-up.ConclusionsNewer intraosseous techniques may enable faster and more reliable vascular access, and this can lower the threshold for intraosseous access on both adult and paediatric patients in critical situations. We believe that all emergency services that handle critically ill or injured paediatric and adult patients should be familiar with intraosseous techniques.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Emergency intraosseous access in a helicopter emergency medical service: a retrospective study

Sunde

Heradstveit

Vikenes

et al. 2010

Scand J Trauma Resusc Emerg Med

View full text Add to dashboard Cite

show abstract

“…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%