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IO route..isn't the time to appear in our ORs

 

 

INTRODUCTION:

Current European Resuscitation Council (ERC) guidelines recommend intraosseous (IO)vascular access, if intravenous (IV) access is not readily available. Because central venous catheterisation (CVC) is an established alternative for in-hospital resuscitation, we compared IO access versus landmark-based CVC in adults with difficult peripheral veins.

METHODS:

In this prospective observational study we investigated success rates on first attempt and procedure times of IO access versus central venous catheterisation (CVC) in adults (≥18 years of age) withinaccessible peripheral veins under trauma or medical resuscitation in a level I trauma centre emergencydepartment.

RESULTS:

Forty consecutive adults under resuscitation were analysed, each receiving IO access and CVC simultaneously. Success rates on first attempt were significantly higher for IO cannulation than CVC (85%versus 60%, p=0.024) and procedure times were significantly lower for IO access compared to CVC (2.0versus 8.0min, p<0.001). As for complications, failure of IO access was observed in 6 patients, while 2 or more attempts of CVC were necessary in 16 patients. No other relevant complications like infection, bleeding or pneumothorax were observed.

CONCLUSIONS:

IO vascular access is a reliable bridging method to gain vascular access for in-hospital adult patients under resuscitation with difficult peripheral veins. Moreover, IO access is more efficacious with a higher success rate on first attempt and a lower procedure time compared to landmark-based CVC.

There is an increasing body of evidence, supporting the role of intraosseous access in the acute resuscitation situation, where tradiotional IV access is problematic (e.g the severe burns patient).

Dont you think  it is the time to use it in our ORs ??????

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