699 results match your criteria Intraosseous Access


Intraosseous transfusion of hemoglobin vesicles in the treatment of hemorrhagic shock with collapsed vessels in a rabbit model.

Transfusion 2020 Jun 24. Epub 2020 Jun 24.

Department of Chemistry, Nara Medical University, Kashihara, Nara, Japan.

Backgrounds: Intravenous transfusion sometimes encounters difficulty under prehospital conditions when peripheral vessels are collapsed and inaccessible. We investigated whether the cellular type hemoglobin-based oxygen carriers (Hemoglobin Vesicles: HbVs) allow intraosseous administration into blood circulation for the resuscitation of rabbits with severe hemorrhagic shock.

Study Design And Methods: New Zealand white rabbits (2. Read More

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http://dx.doi.org/10.1111/trf.15915DOI Listing

Clinical outcome evaluation of intraosseous vancomycin in total knee arthroplasty.

Arthroplast Today 2020 Jun 7;6(2):220-223. Epub 2020 Mar 7.

Department of Orthopedics & Sports Medicine, Houston Methodist Hospital, Houston, TX, USA.

Background: Vancomycin is a commonly used prophylactic antibiotic for total joint replacement surgery to protect against methicillin-resistant . Studies have suggested intraosseous (IO) infusions provide superior local tissue antibiotic concentration compared with intravenous (IV) access in total knee arthroplasty (TKA). We reviewed patients receiving IO vancomycin before TKA, comparing complication rates to a matched group receiving IV prophylactic vancomycin. Read More

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http://dx.doi.org/10.1016/j.artd.2020.02.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7303475PMC

Non-Hodgkin's Lymphoma of the Anterior Maxilla Mimicking a Chronic Apical Abscess.

J Endod 2020 Jun 18. Epub 2020 Jun 18.

Pacific Oral Surgery & Dental Implant Studio, 26732 Crown Valley Pkwy #531, Mission Viejo, CA 92691 USA.

Non-Hodgkin lymphomas (NHL) are malignant neoplasms of the lymphatic system, typically occurring in the fifth through seventh decade of life. Tumors develop from abnormal lymphocyte proliferation and accumulation. While a majority of NHLs occur in nodal regions, 40% of cases appear in extranodal sites involving the stomach, spleen, Waldeyer's ring, central nervous system, lung, skin, and bone. Read More

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http://dx.doi.org/10.1016/j.joen.2020.06.010DOI Listing

Effect of Flap Design for Enamel Matrix Derivative Application in Intraosseous Defects.

JDR Clin Trans Res 2020 Jun 19:2380084420934731. Epub 2020 Jun 19.

Research Centre for the Study of Periodontal and Peri-implant Diseases, University of Ferrara, Ferrara, Italy.

Objective: To systematically review the literature addressing the focused question: What is the effectiveness of different surgical and nonsurgical procedures combined with enamel matrix derivative (EMD) on clinical, radiographic, and patient-centered outcomes in intraosseous defects?

Methods: Electronic (Medline, Scopus, and Cochrane databases) and hand literature searches were performed for studies including at least 1 treatment arm where EMD had been applied according to 1 of the following procedures: modified Widman flap; papilla preservation variants (PPVs), including papilla preservation technique, modified papilla preservation technique, and simplified papilla preservation technique; minimally invasive variants, including minimally invasive surgical approach and minimally invasive surgical technique; single-flap variants (SFVs), including single-flap approach and modified minimally invasive surgical technique; or nonsurgical application (flapless approach). Data from 42 selected articles were used to perform a network meta-analysis, and a hierarchy of surgical and nonsurgical applications of EMD was built separately for EMD and EMD + graft based on 6- to 12-mo clinical and radiographic outcomes.

Results: Among surgical approaches, EMD was associated with best regenerative outcomes when applied through SFVs, with a mean clinical attachment level gain of 3. Read More

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http://dx.doi.org/10.1177/2380084420934731DOI Listing

Bowel Puncture During Insertion of a Femoral Central Line in the Emergency Department.

Am J Case Rep 2020 Jun 16;21:e924607. Epub 2020 Jun 16.

Department of Critical Care, Dalhousie University, Halifax, Nova Scotia, Canada.

BACKGROUND Central venous catheter (CVC) insertion is commonly performed in the emergency department. The femoral vein is often chosen for insertion of CVCs due to its lower risk for complication. We present a rare complication of bowel puncture during insertion of a femoral CVC in the emergency department in a 46-year-old female. Read More

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http://dx.doi.org/10.12659/AJCR.924607DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7319600PMC

Intraosseous Specimens Submitted to the Laboratory: A Case Report and Review.

Lab Med 2020 Jun 13. Epub 2020 Jun 13.

Department of Pathology, University of Maryland School of Medicine, Baltimore, MD.

Intraosseous (IO) devices are used for vascular access in settings where venous access is initially unobtainable, such as prehospital trauma care or cardiac arrest. While IO devices are effective for infusion of blood, fluids, and medications, there is limited data on the analytical equivalence of specimens taken out of IO devices and peripheral venous blood. Despite this, IO device manufacturers and clinical resources state that IO specimens can be submitted for laboratory analysis. Read More

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http://dx.doi.org/10.1093/labmed/lmaa029DOI Listing

Semi-automatic intraosseous device (EZ-IO) in a paediatric emergency department.

J Paediatr Child Health 2020 Jun 1. Epub 2020 Jun 1.

Division of Pediatric Emergency Medicine, Department of Pediatric Emergency and Critical Care Medicine, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.

Aim: Intraosseous access is an alternative to conventional intravenous access. A number of studies have demonstrated the utility and safety of EZ-IO, a recently introduced semi-automatic intraosseous device. However, few studies have investigated the use of EZ-IO in the paediatric emergency setting. Read More

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http://dx.doi.org/10.1111/jpc.14940DOI Listing

Tibial Intraosseous Administration of Epinephrine Is Effective in Restoring Return of Spontaneous Circulation in a Pediatric Normovolemic But Not Hypovolemic Cardiac Arrest Model.

Pediatr Emerg Care 2020 May 22. Epub 2020 May 22.

From the United States Army Graduate Program of Anesthesia Nursing, San Antonio, TX.

Objective: We compared the efficacy of tibial intraosseous (TIO) administration of epinephrine in a pediatric normovolemic versus hypovolemic cardiac arrest model to determine the incidence of return of spontaneous circulation (ROSC) and plasma epinephrine concentrations over time.

Methods: This experimental study evaluated the pharmacokinetics of epinephrine and/or incidence of ROSC after TIO administration in either a normovolemic or hypovolemic pediatric swine model.

Results: All subjects in the TIO normovolemia cardiac arrest group experienced ROSC after TIO administration of epinephrine. Read More

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http://dx.doi.org/10.1097/PEC.0000000000002127DOI Listing

Exposure and Confidence With Critical Nonairway Procedures: A Global Survey of Pediatric Emergency Medicine Physicians.

Pediatr Emerg Care 2020 May 19. Epub 2020 May 19.

Paediatric Research in Emergency Departments International Collaborative.

Background: Children rarely experience critical illness, resulting in low exposure of emergency physicians (EPs) to critical procedures. Our primary objective was to describe senior EP confidence, most recent performance, and/or supervision of critical nonairway procedures. Secondary objectives were to compare responses between those who work exclusively in PEM and those who do not and to determine whether confidence changed for selected procedures according to increasing patient age. Read More

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http://dx.doi.org/10.1097/PEC.0000000000002092DOI Listing

Iatrogenic humeral anatomic neck fracture after intraosseous vascular access.

Skeletal Radiol 2020 May 18. Epub 2020 May 18.

Department of Radiology, Mayo Clinic Arizona, Phoenix, AZ, USA.

Intraosseous infusion has become a key tool in the resuscitation of critically ill or injured patients, both in pre-hospital settings and in emergency departments. Intraosseous access is obtained through the percutaneous placement of a needle into the medullary space of a bone, thereby allowing access into the systemic venous circulation via the medullary space, which is essential to treat patients in shock, cardiac arrest, airway compromise, or major trauma. This becomes critically important when obtaining conventional intravenous access is difficult or impossible. Read More

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http://dx.doi.org/10.1007/s00256-020-03462-4DOI Listing

Surgical Treatment of Aggressive Intraosseous Cavernous Hemangioma in Maxilla Through Surgical Resection.

J Craniofac Surg 2020 Jul-Aug;31(5):e445-e448

São Leopoldo Mandic Dental School, Santa Casa de Misericórdia Hospital of São Miguel dos Campos, São Miguel dos Campos, Brazil.

Hemangiomas are benign vascular lesions characterized by endothelial vascular proliferation and may demonstrate aggressive clinical features. Intraosseous hemangiomas are uncommon and the maxillary location rare, with few cases described in the literature. The treatment of these lesions varies, however they have a better prognosis when a surgical treatment through resection is performed. Read More

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http://dx.doi.org/10.1097/SCS.0000000000006382DOI Listing

Drugs during cardiopulmonary resuscitation.

Curr Opin Crit Care 2020 Jun;26(3):242-250

Research and Development, Prehospital Emergency Medical Services, Central Denmark Region, Aarhus.

Purpose Of Review: The current narrative review outlines the evidence for the most common drugs given during adult cardiopulmonary resuscitation.

Recent Findings: Two large clinical trials recently made the roles of adrenaline and antiarrhythmic drugs clearer. Adrenaline leads to a substantially higher rate of return of spontaneous circulation and a moderate increase in survival. Read More

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http://dx.doi.org/10.1097/MCC.0000000000000718DOI Listing

[Uncomplicated thrombolysis treatment with rt-PA via an intraosseous access after acute ischemic stroke].

Nervenarzt 2020 Jun;91(6):534-536

Klinik für Neurologie und Neurointensivmedizin, Klinikum Darmstadt GmbH, Grafenstraße 9, 64283, Darmstadt, Deutschland.

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http://dx.doi.org/10.1007/s00115-020-00914-zDOI Listing

Which intravascular access should we use in patients with suspected/confirmed COVID-19?

Resuscitation 2020 06 15;151:8-9. Epub 2020 Apr 15.

Clinic of Emergency Medicine, Medical University of Bialystok, Polish Society of Disaster Medicine, Bialystok, Poland.

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http://dx.doi.org/10.1016/j.resuscitation.2020.04.014DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7158769PMC

USE OF INTRAOSSEOUS ACCESS IN PEDIATRIC EMERGENCY CARE IN GEORGIA.

Georgian Med News 2020 Feb(299):33-38

David Tvildiani Medical University, Tbilisi Georgia.

Intraosseous Access (IO) has obtained an increasingly valued place in emergency medical care cases when peripheral access venous access in not possible. This has also been demonstrated in pediatric settings. The method though has never been applied in Georgia, let alone pediatric emergencies. Read More

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February 2020

Complications of interosseous infusion resulting in a diagnostic dilemma.

Trauma Case Rep 2020 Apr 13;26:100289. Epub 2020 Mar 13.

Southampton general hospital, Southampton, United Kingdom.

Successful revival of a patient with cardiac arrest need vigilant effort on behalf of whole team but sometimes missing a small thing can create disaster. Here we present a case of 58 years old obese lady who was revived from a cardiac arrest secondary to septic shock. Obstruction due to proximal ureteric stone was relieved with JJ stent insertion. Read More

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http://dx.doi.org/10.1016/j.tcr.2020.100289DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7076247PMC

Prehospital Life-Saving Interventions Performed on Pediatric Patients in a Combat Zone: A Multicenter Prospective Study.

Pediatr Crit Care Med 2020 Jul;21(7):e407-e413

Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA.

Objectives: We aimed to describe and evaluate prehospital life-saving interventions performed in a pediatric population in the Afghanistan theater of operations.

Design: Our study was a post hoc, subanalysis of a larger multicenter, prospective, observational study.

Setting: We evaluated casualties enrolled upon admission to one of the nine military medical facilities in Afghanistan between January 2009 and March 2014. Read More

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http://dx.doi.org/10.1097/PCC.0000000000002317DOI Listing

Intraosseous Versus Peripheral Intravenous Access During Out-of-Hospital Cardiac Arrest: a Comparison of 30-Day Survival and Neurological Outcome in the French National Registry.

Cardiovasc Drugs Ther 2020 Apr;34(2):189-197

Univ. Lille, CHU Lille, ULR 2694 - METRICS : Évaluation des technologies de santé et des pratiques médicales, University of Lille, F-59000, Lille, France.

Purpose: To compare intraosseous access with peripheral venous access on adults out-of-hospital cardiac arrest (OHCA) patients' clinical outcomes.

Methods: A national retrospective multicentre study was conducted based on the French National Cardiac Arrest Registry. Comparison of patients (intraosseous vs. Read More

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http://dx.doi.org/10.1007/s10557-020-06952-8DOI Listing

Intravenous vs. intraosseous administration of drugs during cardiac arrest: A systematic review.

Resuscitation 2020 Apr 3;149:150-157. Epub 2020 Mar 3.

Department of Anaesthesiology and Intensive Care, Randers Regional Hospital, Randers, Denmark; Research Center for Emergency Medicine, Department of Clinical Medicine, Aarhus University Hospital and Aarhus University, Aarhus, Denmark; Center for Resuscitation Science, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA. Electronic address:

Aim: To perform a systematic review of the literature on intravenous (IV) vs. intraosseous (IO) administration of drugs during cardiac arrest in order to inform an update of international guidelines.

Methods: The review was performed according to PRISMA guidelines and registered on PROSPERO. Read More

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http://dx.doi.org/10.1016/j.resuscitation.2020.02.025DOI Listing

Prehospital transfusion of low titer cold-stored whole blood through the intraosseous route in a trauma patient with hemorrhagic shock.

Transfusion 2020 Apr 26;60(4):875-878. Epub 2020 Feb 26.

Rappaport Faculty of Medicine, Technion-Institute of Technology, Haifa, Israel.

Background: Damage control resuscitation, avoidance of dilutional coagulopathy, and increased blood component therapy reduce mortality after major trauma hemorrhage. Improved outcomes seen in recent warfare have placed whole blood as the preferred product for resuscitation of severe traumatic hemorrhage. As of 2018, flight physicians of the Israeli Airborne Combat Search and Rescue Unit (ACSRU) treat these patients with low titer cold-stored O-positive whole blood (LTCSO WB). Read More

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http://dx.doi.org/10.1111/trf.15732DOI Listing

Intraosseous adrenaline for adult out-of-hospital cardiac arrest: Faster access with worse outcomes.

Resuscitation 2020 Apr 18;149:238-239. Epub 2020 Feb 18.

The Children's Hospital of Philadelphia, Anesthesiology and Critical Care Medicine, 34th Street & Civic Center Blvd., South Tower-Rm#7C26, Philadelphia, PA 19104-4399, United States. Electronic address:

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http://dx.doi.org/10.1016/j.resuscitation.2020.02.009DOI Listing

Intraosseous access in the resuscitation of trauma patients: a literature review.

Eur J Trauma Emerg Surg 2020 Feb 20. Epub 2020 Feb 20.

Centre for Trauma Sciences, Blizard Institute, Queen Mary University of London, 4 Newark Street, London, E1 2AT, UK.

Purpose: Intraosseous (IO) catheters continue to be recommended in trauma resuscitation. Their utility has recently been debated due to concerns regarding inadequate flow rates during blood transfusion, and the potential for haemolysis. The objective of this review was to examine the evidence for intraosseous catheters in trauma resuscitation, and to highlight areas for future research. Read More

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http://dx.doi.org/10.1007/s00068-020-01327-yDOI Listing
February 2020
0.380 Impact Factor

Intravenous and Intraosseous Blood Transfusion With Three Different Pediatric Pressure Transfusion Strategies in an Immature Swine (Sus scrofa) Model of Hemorrhagic Shock: A Pilot Study.

Mil Med 2020 01;185(Suppl 1):121-129

Naval Medical Center Portsmouth, Department of Emergency Medicine, Combat Trauma Research Group.

Introduction: Exsanguination remains the leading cause of preventable death in military conflicts, and pediatric casualties are common. Transfusion is crucial to preserve life, but vascular access is challenging in children, so intraosseous (IO) access is often required. However, the optimal transfusion method is unclear. Read More

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http://dx.doi.org/10.1093/milmed/usz200DOI Listing
January 2020

The history of bone marrow in orthopaedic surgery (part I trauma): trepanning, bone marrow injection in damage control resuscitation, and bone marrow aspiration to heal fractures.

Int Orthop 2020 04 15;44(4):795-808. Epub 2020 Feb 15.

Hôpital Henri Mondor, 94010, Creteil, France.

Purpose: One of the oldest procedures performed by man is trepanning of the bone and yet it was only in the last 40 years that bone marrow aspiration has been used to treat nonunion disorders.

Material And Methods: These advances were possible due to improvements in instruments and in techniques to make holes in the bone, an history that began with skull trephinations around 8000-10,000 years ago, and continued with sternum bone marrow injection for trauma resuscitation in the beginning of the twentieth century; this procedure had improved at the beginning of the twenty-first century to allow pelvis bone marrow aspiration for the treatment of nonunion.

Results: Trephined skulls from antiquity have been found in many parts of world, showing that trephining was ancient and widespread. Read More

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http://dx.doi.org/10.1007/s00264-020-04506-zDOI Listing

Intraosseous versus intravenous administration of adrenaline in patients with out-of-hospital cardiac arrest: a secondary analysis of the PARAMEDIC2 placebo-controlled trial.

Intensive Care Med 2020 May 30;46(5):954-962. Epub 2020 Jan 30.

Warwick Clinical Trials Unit, University of Warwick, Coventry, CV4 7AL, UK.

Purpose: To compare the effectiveness of the intravenous (IV) and intraosseous (IO) routes for drug administration in adults with a cardiac arrest enrolled in the Pre-Hospital Assessment of the Role of Adrenaline: Measuring the Effectiveness of Drug Administration in Cardiac Arrest (PARAMEDIC2) randomised, controlled trial.

Methods: Patients were recruited from five National Health Service Ambulance Services in England and Wales from December 2014 through October 2017. Patients with an out-of-hospital cardiac arrest who were unresponsive to initial resuscitation attempts were randomly assigned to 1 mg adrenaline or matching placebo. Read More

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http://dx.doi.org/10.1007/s00134-019-05920-7DOI Listing

Intravenous versus intraosseous adrenaline administration in out-of-hospital cardiac arrest: A retrospective cohort study.

Resuscitation 2020 Apr 23;149:209-216. Epub 2020 Jan 23.

University of Texas, Southwestern Medical Center, 5323 Harry Hines BLVD, Dallas, Texas 75390-8579, USA.

Background: Adrenaline is an important component in the resuscitation of individuals experiencing out-of-hospital cardiac arrest (OHCA). The 2018 Advanced Cardiac Life Support (ACLS) algorithm gives the option of either intravenous (IV) or intraosseous (IO) routes for adrenaline administration during cardiac arrest. However, the optimal route during prehospital resuscitation remains controversial. Read More

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http://dx.doi.org/10.1016/j.resuscitation.2020.01.009DOI Listing

Natural language processing of prehospital emergency medical services trauma records allows for automated characterization of treatment appropriateness.

J Trauma Acute Care Surg 2020 May;88(5):607-614

From the Department of Surgery (C.J.T., G.B., G.B.M.), University of Minnesota, Minneapolis, Minnesota; Institute for Health Informatics (C.J.T., G.M.S., R.F., R.M., B.C.K., S.P., E.A.L., G.B.M.), University of Minnesota, Minneapolis, Minnesota; Department of Surgery (C.J.T., J.L.G.), North Memorial Health Hospital, Robbinsdale, Minnesota; North Memorial Health Hospital Emergency Medical Services (A.L.T.), Robbinsdale, Minnesota; and Department of Emergency Medicine (J.W.L.), North Memorial Health Hospital Emergency Medical Services, Robbinsdale, Minnesota.

Background: Incomplete prehospital trauma care is a significant contributor to preventable deaths. Current databases lack timelines easily constructible of clinical events. Temporal associations and procedural indications are critical to characterize treatment appropriateness. Read More

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http://dx.doi.org/10.1097/TA.0000000000002598DOI Listing

Survival After Intravenous Versus Intraosseous Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Shock-Refractory Cardiac Arrest.

Circulation 2020 01 16;141(3):188-198. Epub 2020 Jan 16.

Department of Medicine, Division of Cardiology (P.J.K.), University of Washington, Seattle.

Background: Antiarrhythmic drugs have not proven to significantly improve overall survival after out-of-hospital cardiac arrest from shock-refractory ventricular fibrillation/pulseless ventricular tachycardia. How this might be influenced by the route of drug administration is not known.

Methods: In this prespecified analysis of a randomized, placebo-controlled clinical trial, we compared the differences in survival to hospital discharge in adults with shock-refractory ventricular fibrillation/pulseless ventricular tachycardia out-of-hospital cardiac arrest who were randomly assigned by emergency medical services personnel to an antiarrhythmic drug versus placebo in the ALPS trial (Resuscitation Outcomes Consortium Amiodarone, Lidocaine or Placebo Study), when stratified by the intravenous versus intraosseous route of administration. Read More

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http://dx.doi.org/10.1161/CIRCULATIONAHA.119.042240DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7009320PMC
January 2020
14.430 Impact Factor

Pharmacokinetics of Tranexamic Acid via Intravenous, Intraosseous, and Intramuscular Routes in a Porcine (Sus scrofa) Hemorrhagic Shock Model.

J Spec Oper Med 2019 ;19(4):80-84

Background: Intravenous (IV) tranexamic acid (TXA) is an adjunct for resuscitation in hemorrhagic shock; however, IV access in these patients may be difficult or impossible. Intraosseous (IO) or intramuscular (IM) administration could be quickly performed with minimal training. We investigated the pharmacokinetics of TXA via IV, IO, and IM routes in a swine model of controlled hemorrhagic shock. Read More

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January 2020

Intraosseous access in adults in cardiac arrest: a systematic review and meta-analysis.

Emergencias 2020 Feb;32(1):49-56

Instituto Maimónides de Investigación Biomédica de Córdoba, España.

Objectives: To evaluate the efficacy of intraosseous access versus venous access in out-of-hospital cardiac arrest in terms of return of spontaneous circulation (ROSC) and survival to hospital discharge with or without favorable neurologic status.

Material And Methods: Systematic review and meta-analysis of articles indexed in MEDLINE (PubMed), Embase, the Web of Science, and the Cochrane Library. Other terms adapted to the language of each index were also used. Read More

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February 2020

An anatomical investigation into the blood supply of the proximal humerus: surgical considerations for rotator cuff repair.

JSES Open Access 2019 Dec 18;3(4):320-327. Epub 2019 Nov 18.

Department of Orthopaedic Surgery and Sports Medicine, Valiant Clinic/Houston Methodist Group, Dubai, United Arab Emirates.

Background: The purpose of this study was to investigate the blood supply of the humeral head (HH) originating from the anterior (ACHA) and posterior circumflex humeral arteries (PCHA).

Methods: Formalin preserved specimens were used to measure ACHA length, ACHA length in the bicipital groove (BG), the length of the ascending branch of the ACHA, the penetration point of the ascending branch of the ACHA at the greater tuberosity (GT), and the penetration point of the ascending branch PCHA at the GT. Fresh specimens were used to identify the intraosseous vascular network by both the ACHA and PCHA by injecting a contrast medium using a high-resolution microfocus computed tomography. Read More

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http://dx.doi.org/10.1016/j.jses.2019.09.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6928301PMC
December 2019

Osteomyelitis after Intraosseous Cannulation in a Child.

Case Rep Orthop 2019 6;2019:7170154. Epub 2019 Dec 6.

Department of Orthopaedic Surgery, Albany Medical Center, Albany, New York 12208, USA.

osteomyelitis secondary to intraosseous (IO) cannulation is not well documented in literature. We report here an extremely rare incident of tibial osteomyelitis at the IO access site, in a 4-year-old child, who presented 3 months after an episode of fluid resuscitation for streptococcal toxic shock syndrome necessitating irrigation and debridement and prolonged antibiotic therapy. We advocate for heightened awareness of osteomyelitis in patients with continued pain after IO cannulation. Read More

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http://dx.doi.org/10.1155/2019/7170154DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6925771PMC
December 2019

A Pulse Check on Leadership and Teamwork: An Evaluation of the First 5 Minutes of Emergency Department Resuscitation During Pediatric Cardiopulmonary Arrests.

Pediatr Emerg Care 2019 Dec 13. Epub 2019 Dec 13.

From the Division of Emergency Medicine, Children's National Health System, Washington, DC.

Objectives: Effective leadership and teamwork are imperative during pediatric cardiopulmonary resuscitations (CPR). The initial phase of pediatric CPR, termed the "first 5 minutes," has significant care delivery gaps in both leadership and team performance. The aim of the study was to describe the performance data of emergency department (ED) teams who performed CPR in a pediatric ED. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001923DOI Listing
December 2019

Ultrasound-guidance for intraosseous access could improve resuscitation maneuvers. A retrospective data report on Italian earthquake victims.

Minerva Anestesiol 2020 03 6;86(3):357-358. Epub 2019 Dec 6.

Unit of Anesthesia, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.

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http://dx.doi.org/10.23736/S0375-9393.19.14072-2DOI Listing

Ultrasound-guided techniques for peripheral intravenous placement in children with difficult venous access.

Paediatr Anaesth 2020 02 19;30(2):108-115. Epub 2019 Dec 19.

Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, ON, Canada.

Peripheral intravenous placement in children can be challenging. Different techniques have been used to improve first pass success rates in children with known history of difficult venous access including surface landmarking, local warming, transillumination, ultrasonography, epidermal nitroglycerin, central venous access, intraosseous placement, and venous cutdown. Among these, ultrasound guidance has garnered the most interest among anesthesiologists. Read More

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http://dx.doi.org/10.1111/pan.13780DOI Listing
February 2020

A Video-Based, Case-Control Study of Factors Associated With Intraosseous Catheterization During Pediatric Resuscitation.

Ann Emerg Med 2020 06 3;75(6):755-761. Epub 2019 Dec 3.

Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH; Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.

Study Objective: Factors associated with intraosseous (IO) catheterization are not well described. Our objective is to identify factors associated with the attempt and timing of IO catheterization in a pediatric emergency department (ED) resuscitation setting.

Methods: We completed a video-based, case-control study (1:3 ratio) of children undergoing IO catheterization in the resuscitation area of a high-volume, academic, pediatric ED. Read More

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http://dx.doi.org/10.1016/j.annemergmed.2019.09.005DOI Listing

Intraosseous administration of 4-factor prothrombin complex concentrate prior to emergent surgery after receiving apixaban.

J Clin Pharm Ther 2020 Jun 5;45(3):577-579. Epub 2019 Dec 5.

Department of Pharmacy Services, Saint Joseph Hospital, Lexington, KY, USA.

What Is Known And Objective: The 4-factor prothrombin complex concentrate (4F-PCC) may be used to emergently achieve haemostasis in patients on anticoagulation prior to surgery. Limited data exist using the intraosseous route of administration of 4F-PCC in patients taking factor Xa inhibitors.

Case Description: We describe a case of a 69-year-old female receiving oral apixaban that was successfully administered 4F-PCC using intraosseous access prior to emergent surgery to obtain haemostasis intraoperatively. Read More

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http://dx.doi.org/10.1111/jcpt.13094DOI Listing

Immersive simulation training at 6-week intervals for 1 year and multidisciplinary team performance scores: a randomized controlled trial of simulation training for life-threatening pediatric emergencies.

Emergencias 2019 Dic;31(6):391-398

ABS Lab, Simulation Center, Faculty of Medicine, University of Poitiers, Francia. Pediatric Emergency Department, University Hospital of Poitiers, Francia.

Objectives: To demonstrate an effect of 1 year of training using immersive simulations repeated every 6 weeks versus every 6 months to improve the performance of multidisciplinary teams (MDTs) working with children in lifethreatening situations.

Material And Methods: Randomized controlled trial in 12 MDTs of emergency responders in France. Each MDT consisted of 4 persons: a physician, a resident, a nurse, and the ambulance driver. Read More

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November 2019

Tibial Intraosseous Insertion in Pediatric Emergency Care: A Review Based upon Postmortem Computed Tomography.

Prehosp Emerg Care 2020 Jan 7:1-7. Epub 2020 Jan 7.

The proximal tibia is a recommended and commonly used site for pediatric emergency intraosseous vascular access (IO). During forensic whole body postmortem computed tomography (PMCT), we evaluated accuracy of emergency placement of tibial IO access. We conducted a retrospective review of 92 state medical examiner cases to assess presence and placement of tibial IO needles. Read More

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http://dx.doi.org/10.1080/10903127.2019.1698682DOI Listing
January 2020

Effectiveness of Prophylactic Intraosseous Antibiotic versus Intravenous Antibiotic in Knee Surgeries in Pigs: Experimental Study.

Rev Bras Ortop (Sao Paulo) 2019 Sep 29;54(5):556-563. Epub 2019 Oct 29.

Serviço de Cirurgia de Urgência de Trauma, Hospital e Maternidade Celso Pierro, Pontifícia Universidade Católica de Campinas, Campinas, SP, Brasil.

 To demonstrate that the intraosseous (IO) access is more effective compared with the intravenous (IV) access for prophylactic antibiotic administration in knee joint surgeries, using 36 pigs as live models.  Skin, subcutaneous tissue, cartilage, and bone samples were collected, analyzed and compared after the administration of IV or IO antibiotic in different groups.  When comparing the IO and IV groups, the IO group showed a higher concentration of prophylactic antibiotic in the skin (  = 0. Read More

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http://dx.doi.org/10.1016/j.rbo.2017.12.011DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6855918PMC
September 2019

Noninvasive analysis and identification of an intramuscular fluid collection by postmortem H-MRS in a case of a fatal motor vehicle accident.

Int J Legal Med 2020 May 12;134(3):1167-1174. Epub 2019 Nov 12.

Institute of Forensic Medicine, Department of Forensic Medicine and Imaging, University of Zurich, Zurich, Switzerland.

In a case of a fatal traffic accident, a suspicious finding was identified in the muscular tissue of the left thigh by whole-body postmortem computed tomography. To better interpret the finding, the lower extremities were investigated by magnetic resonance imaging (MRI) and proton magnetic resonance spectroscopy (H-MRS). MRI revealed the presence of an evenly distributed intramuscular fluid and H-MRS of a volume within the fluid detected concentrations of acetate and lactate. Read More

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http://dx.doi.org/10.1007/s00414-019-02190-2DOI Listing

Intramuscular hemorrhage and fluid extravasation into the anterior compartment secondary to intraosseous resuscitation, the "Nicked-Cortex" sign.

Radiol Case Rep 2019 Nov 3;14(11):1452-1457. Epub 2019 Oct 3.

Jacksonville University, Jacksonville, FL, USA.

Intraosseous needle access is a reliable method of vascular access used for rapid fluid resuscitation and delivery of medications in certain emergent settings. Fluid extravasation is a possible complication of intraosseous needle access that can lead to compartment syndrome. To our knowledge, imaging findings resulting from this complication have not been described. Read More

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http://dx.doi.org/10.1016/j.radcr.2019.09.013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6823788PMC
November 2019
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Intraosseous Administration of Hypertonic Saline in Acute Brain-Injured Patients: A Prospective Case Series and Literature Review.

Neurologist 2019 Nov;24(6):176-179

Neurocritical Care Unit, Ohio State University Wexner Medical Center, Columbus, OH.

Background: Central venous catheters are often used to administer hypertonic saline (HTS) but might be associated with serious complications. Intraosseous (IO) access is an alternative method of medication and fluid delivery which is not associated with life-threatening complications and can be inserted faster than CVCs.

Methods: A prospective case series was conducted on critically ill neurological patients that did not have central venous access, and for whom 3% HTS was indicated. Read More

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http://dx.doi.org/10.1097/NRL.0000000000000248DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6839785PMC
November 2019
1.078 Impact Factor

Compartment Syndrome of the Leg after Intraosseous (IO) Needle Insertion.

Ann Vasc Surg 2020 May 30;65:282.e9-282.e11. Epub 2019 Oct 30.

Division of Vascular Surgery, Vascular Institute of New York, NYU-Langone-Brooklyn, Brooklyn, NY.

Intraosseous (IO) needles are used in patients who are critically ill when it is not possible to obtain venous access. While IO allows for immediate access, IO infusions are associated with complications including fractures, infections, and compartment syndrome. We present a case of an 87-year-old man who developed lower extremity compartment syndrome after receiving an IO needle insertion and had to be treated surgically with fasciotomy to correct the problem. Read More

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http://dx.doi.org/10.1016/j.avsg.2019.10.066DOI Listing
May 2020
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Use of Intraosseous Needles in Neonates: A Systematic Review.

Neonatology 2019 28;116(4):305-314. Epub 2019 Oct 28.

Newborn Services, John Radcliffe Hospital, Oxford University Hospitals, NHS Foundation Trust, Oxford, United Kingdom.

Background: The use of intraosseous (IO) access during resuscitation is widely accepted and promoted in paediatric medicine but features less prominently in neonatal training. Whilst umbilical venous catheterization (UVC) is a reliable method of delivering emergency drugs and fluids, it is not always achievable in a timely manner. IO access warrants exploration as an alternative. Read More

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http://dx.doi.org/10.1159/000502212DOI Listing

Single-Flap Approach in Periodontal Regeneration for Intraosseous Defects: Case Series.

Clin Adv Periodontics 2020 Jun 14;10(2):69-74. Epub 2019 Nov 14.

Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD.

Introduction: A single-flap approach (SFA) is the elevation of a periodontal flap to access the defect only from one side. Several studies have reported that the SFA is at least as clinically effective as the elevation of a flap at both buccal and palatal/lingual aspects. However, studies regarding the SFA have reported only 6 to 10 months follow-up clinical outcomes. Read More

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http://dx.doi.org/10.1002/cap.10082DOI Listing
June 2020
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