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    563 results match your criteria Intraosseous Access

    1 OF 12

    Comparison of four different intraosseous access devices during simulated pediatric resuscitation. A randomized crossover manikin trial.
    Eur J Pediatr 2017 May 12. Epub 2017 May 12.
    Department of Outcomes Research, Cleveland Clinic, Cleveland, OH, USA.
    The aim of the study was to compare the success rate, procedure time, and user satisfaction of pediatric NIO™ compared to Pediatric BIG®, EZ-IO®, and Jamshidi intraosseous access devices. This was a randomized, crossover manikin trial with 87 paramedics. The correct location of intraosseous access when using NIO, BIG, EZ-IO, and Jamshidi was varied and was respectively 100, 90, 90, and 90%. Read More

    Improving CPR performance.
    Chest 2017 May 9. Epub 2017 May 9.
    division of Cardiovascular Medicine, Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA.
    Cardiac arrest continues to represent a public health burden with most patients having dismal outcomes. Cardiopulmonary resuscitation (CPR) is a complex set of interventions requiring leadership, coordination, and best practices. Despite the widespread adoption of new evidence in various guidelines, the provision of CPR remains variable with poor adherence to published recommendations. Read More

    A randomised crossover study to compare the cross-sectional and longitudinal approaches to ultrasound-guided peripheral venepuncture in a model.
    Crit Ultrasound J 2017 Dec 3;9(1). Epub 2017 Apr 3.
    Emergency Department, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
    Background: Ultrasound-guided peripheral intravenous access may present an alternative to central or intraosseous access in patients with difficult peripheral veins. Using venepuncture of a phantom model as a proxy, we investigated whether novice ultrasound users should adopt a cross-sectional or longitudinal approach when learning to access peripheral veins under ultrasound guidance. This result would inform the development of a structured training method for this procedure. Read More

    The use of intraosseous needles for injection of contrast media for computed tomographic angiography of the thoracic aorta.
    J Cardiovasc Comput Tomogr 2017 May - Jun;11(3):203-207. Epub 2017 Mar 16.
    Department of Radiology, Stanford University, Stanford, CA, USA.
    Background: The objective of this study is to evaluate the safety and quality of computed tomographic angiography of the thoracic aorta (CTA-TA) exams performed using intraosseous needle intravenous access (ION-IVA) for contrast media injection (CMI).

    Methods: All CTA-TA exams at the study institution performed between 1/1/2013 and 8/14/2015 were reviewed retrospectively to identify those exams which had been performed using ION-IVA (ION-exams). ION-exams were then analyzed to determine aortic attenuation and contrast-to-noise ratio (CNR). Read More

    Two Decades of Saving Lives on the Battlefield: Tactical Combat Casualty Care Turns 20.
    Mil Med 2017 Mar;182(3):e1563-e1568
    Committee on Tactical Combat Casualty Care, Joint Trauma System, U.S. Army Institute of Surgical Research, Joint Base San Antonio, San Antonio, TX 78234.
    Background: Twenty years ago, the original Tactical Combat Casualty Care (TCCC) article was published in this journal. Since TCCC is essentially a set of best-practice prehospital trauma care guidelines customized for use on the battlefield, the presence of a journal with a specific focus on military medicine was a profound benefit to the initial presentation of TCCC to the U.S. Read More

    Intravenous vs. intraosseous access and return of spontaneous circulation during out of hospital cardiac arrest.
    Am J Emerg Med 2017 Feb 24;35(2):222-226. Epub 2016 Oct 24.
    Department of Emergency Medicine, University at Buffalo, University Emergency Medicine Services, 462 Grider Street, Buffalo, NY 14215, USA. Electronic address:
    Introduction: Guidelines endorse intravenous (IV) and intraosseous (IO) medication administration for cardiac arrest treatment. Limited clinical evidence supports this recommendation. A multiagency, retrospective study was performed to determine the association between parenteral access type and return of spontaneous circulation (ROSC) in out of hospital cardiac arrest. Read More

    The Resuscitative and Pharmacokinetic Effects of Humeral Intraosseous Vasopressin in a Swine Model of Ventricular Fibrillation.
    Prehosp Disaster Med 2017 Mar 8:1-6. Epub 2017 Mar 8.
    5Department of Anesthesia,Madigan Army Medical Center,Fort Lewis,WashingtonUSA.
    Introduction The American Heart Association (AHA; Dallas, Texas USA) and European Resuscitation Council (Niel, Belgium) cardiac arrest (CA) guidelines recommend the intraosseous (IO) route when intravenous (IV) access cannot be obtained. Vasopressin has been used as an alternative to epinephrine to treat ventricular fibrillation (VF). Hypothesis/Problem Limited data exist on the pharmacokinetics and resuscitative effects of vasopressin administered by the humeral IO (HIO) route for treatment of VF. Read More

    Intraosseous access can be taught to medical students using the four-step approach.
    BMC Med Educ 2017 Mar 2;17(1):50. Epub 2017 Mar 2.
    Copenhagen Academy for Medical Education and Simulation, Capital Region of Denmark, Herlev, Denmark.
    Background: The intraosseous (IO) access is an alternative route for vascular access when peripheral intravascular catheterization cannot be obtained. In Denmark the IO access is reported as infrequently trained and used. The aim of this pilot study was to investigate if medical students can obtain competencies in IO access when taught by a modified Walker and Peyton's four-step approach. Read More

    Long-term follow-up of two patients with retained intraosseous sternal needles.
    J R Army Med Corps 2017 Mar 1. Epub 2017 Mar 1.
    Department of Trauma and Orthopaedics, Royal Centre for Defence Medicine, Queen Elizabeth Hospital Birmingham, Birmingham, UK.
    Sternal intraosseous devices are widely used in both civilian and military trauma when vascular access is difficult to establish. We discuss a rare complication of intraosseous needle insertion in two patients where the needle tip remained in the sternum after the device had been removed. Neither patient had evidence of any complication of the retained intraosseous needle tip after >6 years of follow-up. Read More

    [Intramedullary placement of intraosseous cannulas inserted in the preclinical treatment of polytrauma patients : A retrospective, computed tomography-assisted evaluation].
    Anaesthesist 2017 Mar 23;66(3):168-176. Epub 2017 Feb 23.
    Klinik für Anästhesiologie, Intensiv-, Notfall-, Transfusionsmedizin und Schmerztherapie, Evangelisches Krankenhaus, Bielefeld, Deutschland.
    Background: Use of intraosseous access to the vascular system is rare in the pre-hospital setting (<1%). However, as patients for which the use of an intraosseous device is indicated are usually in a critical condition, awareness of possible application errors is vital. A survey was performed to evaluate intramedullary needle placement by means of computed axial tomography. Read More

    Deltoid Compartment Syndrome: A Rare Complication after Humeral Intraosseous Access.
    Plast Reconstr Surg Glob Open 2017 Jan 24;5(1):e1208. Epub 2017 Jan 24.
    Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.
    We present a case of a 65-year-old woman who developed a delayed deltoid compartment syndrome after resuscitation via humeral intraosseous access. Initially she was treated conservatively but then was taken emergently for a fasciotomy. After confirming the diagnosis with compartment pressures, a 2-incision approach was employed and a large hematoma was evacuated from the inferior margin of the anterior deltoid. Read More

    The effects of sternal intraosseous and intravenous administration of amiodarone in a hypovolemic swine cardiac arrest model.
    Am J Disaster Med 2016 Fall;11(4):271-277
    Faculty Member and Co-Director of Research, US Army Graduate Program in Anesthesia Nursing, Fort Sam Houston, San Antonio, Texas.
    Objective: This study compared the effects of amiodarone via sternal intraosseous (SIO) and intravenous (IV) routes on return of spontaneous circulation (ROSC), time to ROSC, concentration maximum (Cmax), time to maximum concentration (Tmax), and mean concentrations over time in a hypovolemic cardiac arrest model.

    Design: Prospective, between subjects, randomized experimental design.

    Setting: TriService Research Facility. Read More

    Effects of humerus intraosseous versus intravenous amiodarone administration in a hypovolemic porcine model.
    Am J Disaster Med 2016 Fall;11(4):261-269
    US Army Graduate Program in Anesthesia Nursing, JBSA-FSH, San Antonio, Texas.
    Objective: To compare the effects of amiodarone administration by humerus intraosseous (HIO) and intravenous (IV) routes on return of spontaneous circulation (ROSC), time to maximum concentration (Tmax), maximum plasma drug concentration (Cmax), time to ROSC, and mean concentrations over time in a hypovolemic cardiac arrest model.

    Design: Prospective, between subjects, randomized experimental design.

    Setting: TriService Research Facility. Read More

    The effects of tibial intraosseous versus intravenous amiodarone administration in a hypovolemic cardiac arrest procine model.
    Am J Disaster Med 2016 Fall;11(4):253-260
    Faculty Member and Director of Research, US Army Graduate Program in Anesthesia Nursing, Fort Sam Houston, San Antonio, Texas.
    Objective: This study compared the effects of amiodarone via tibial intraosseous (TIO) and intravenous (IV) routes on return of spontaneous circulation (ROSC), time to ROSC, maximum drug concentration (Cmax), time to maximum concentration (Tmax), and mean concentrations over time in a hypovolemic cardiac arrest model.

    Design: Prospective, between subjects, randomized experimental design.

    Setting: TriService Research Facility. Read More

    Effects of tibial and humerus intraosseous administration of epinephrine in a cardiac arrest swine model.
    Am J Disaster Med 2016 Fall;11(4):243-251
    US Army Graduate Program in Anesthesia Nursing, JBSA-FSH, San Antonio, Texas.
    Objective: Compare maximum concentration (Cmax), time to maximum concentration (Tmax), mean serum concentration of epinephrine, return of spontaneous circulation (ROSC), time to ROSC, and odds of survival relative to epinephrine administration by humerus intraosseous (HIO), tibial intraosseous (TIO), and intravenous (IV) routes in a swine cardiac arrest model.

    Design: Prospective, between subjects, randomized experimental design.

    Setting: TriService Research Facility. Read More

    The comparison of humeral intraosseous and intravenous administration of vasopressin on return of spontaneous circulation and pharmacokinetics in a hypovolemic cardiac arrest swine model.
    Am J Disaster Med 2016 Fall;11(4):237-242
    Director of Research, US Army Graduate Program in Anesthesia Nursing, Fort Sam Houston, JBSA-FSH, San Antonio, Texas.
    Introduction: The American Heart Association (AHA) recommends intravenous (IV) or intraosseous (IO) vasopressin in Advanced Cardiac Life Support (ACLS). Obtaining IV access in hypovolemic cardiac arrest patients can be difficult, and IO access is often obtained in these life threatening situations. No studies have been conducted to determine the effects of humeral IO (HIO) access with vasopressin in the return of spontaneous circulation (ROSC). Read More

    En route intraosseous access performed in the combat setting.
    Am J Disaster Med 2016 Fall;11(4):225-231
    United States Air Force En Route Care Research Center/59th MDW/ST-United States Army Institute of Surgical Research, JBSA Ft. Sam Houston, Texas; Department of Emergency Medicine, San Antonio Military Medical Center, JBSA Ft. Sam Houston, Texas.
    Objective: To describe and compare vascular access practices used by en route care providers during medical evacuation (MEDEVAC).

    Design: This was a retrospective cohort study. Medical records of US military personnel injured in combat and transported by MEDEVAC teams were queried. Read More

    Effects of tibial and humerus intraosseous and intravenous vasopressin in porcine cardiac arrest model.
    Am J Disaster Med 2016 Summber;11(3):211-218
    US Army Graduate Program in Anesthesia Nursing, JBSA-FSH, San Antonio, Texas.
    Objective: Compare maximum concentration (Cmax), time to maximum concentration (Tmax), mean serum concentration of vasopressin, return of spontaneous circulation (ROSC), time to ROSC, and odds of survival relative to vasopressin administration by tibial intraosseous (TIO), humerus intraosseous (HIO), and intravenous (IV) routes in a hypovolemic cardiac arrest model.

    Design: Prospective, between subjects, randomized experimental design.

    Setting: TriService Research Facility. Read More

    The effects of sternal and intravenous vasopressin administration on pharmacokinetics.
    Am J Disaster Med 2016 Summber;11(3):203-209
    Professor and Director of Research, US Army Graduate Program in Anesthesia Nursing, Joint Base San Antonio-Fort Sam Houston, San Antonio, Texas.
    Objective: Purposes of this study were to compare intravenous (IV) and sternal intraosseous (SIO) administration of vasopressin relative to concentration maximum (Cmax), time to maximum concentration (Tmax), and mean concentration in a cardiac arrest model.

    Design: Prospective, between subjects, randomized experimental design.

    Setting: Vivarium. Read More

    Effects of tibial intraosseous and intravenous administration of Hextend on time of administration and hemodynamics in a hypovolemic swine model.
    Am J Disaster Med 2016 Summber;11(3):193-201
    Faculty Member, US Army Graduate Program in Anesthesia Nursing, Fort Sam Houston, San Antonio, Texas.
    Objective: To determine if there were significant differences between the tibial intraosseous (TIO) and intravenous (IV) administration of Hextend relative to time and in hemodynamics in a hypovolemic model.

    Setting: Vivarium.

    Subjects: Yorkshire swine; sample size was based on a power of 80 percent, α of 0. Read More

    Effects of intravenous, sternal, and humerus intraosseous administration of Hextend on time of administration and hemodynamics in a hypovolemic swine model.
    Am J Disaster Med 2016 Summber;11(3):183-192
    Texas Tech University Health Science Center at El Paso, El Paso, Texas.
    Objective: To determine if there were significant differences among humerus intraosseous (HIO), sternal intraosseous (SIO), and intravenous (IV) administration of 500 mL Hextend in hemodynamics or administration time in a hypovolemic swine model.

    Setting: Vivarium.

    Subjects: Yorkshire swine; sample size was based on a large effect size of 0. Read More

    A primer on intraosseous access: History, clinical considerations, and current devices.
    Am J Disaster Med 2016 Summber;11(3):167-173
    Research Scientist, The Geneva Foundation for Military Medical Research, Tacoma, Washington; Adjunct Associate Professor, Doctorate of Nurse Anesthesia Program, College of Health Sciences, Midwestern University, Glendale, Arizona.
    Objective: Intraosseous (IO) access is a method recommended by the American Heart Association and the European Resuscitation Council to administer resuscitative drugs and fluids when intravenous (IV) access cannot be rapidly or easily obtained. Many clinicians have limited knowledge or experience with the IO route. The purpose of this review was to provide the reader with a succinct review of the history, clinical considerations, and devices associated with IO access. Read More

    Intraosseous vascular access in disasters and mass casualty events: A review of the literature.
    Am J Disaster Med 2016 Summber;11(3):149-166
    Research Scientist, The Geneva Foundation for Military Medical Research, Tacoma, Washington; Adjunct Associate Professor, Doctorate of Nurse Anesthesia Program, College of Health Sciences, Midwestern University, Glendale, Arizona.
    Objective: The intraosseous (IO) route of vascular access has been increasingly used to administer resuscitative fluids and drugs to patients in whom reliable intravenous (IV) access could not be rapidly or easily obtained. It is unknown that to what extent the IO route has been used to gain vascular access during disasters and mass casualty events. The purpose of this review was to examine the existing literature to answer the research question, "What is the utility of the IO route compared to other routes for establishing vascular access in patients resulting from disasters and mass casualty events?"

    Design: Keyword-based online database search of PubMed, CINAHL, and the Cochrane Database of Systematic Reviews. Read More

    Time to epinephrine in out-of-hospital cardiac arrest: A retrospective analysis of intraosseous versus intravenous access.
    Am J Disaster Med 2016 Spring;11(2):119-123
    Medical Director, Office of the Medical Director, University of Texas Health Science Center at San Antonio, San Antonio, Texas.
    Introduction: The 2015 advanced cardiac life support update continues to advocate administering epinephrine during cardiac arrest. The goal of our study is to determine if prehospital intraosseous (IO) access results in shorter time to epinephrine than prehospital peripheral intravenous (PIV) access.

    Methods: The out-of-hospital cardiac arrest (OHCA) database of a large, urban, fire-based emergency medical services system was searched for consecutive cases of OHCA between January 2013 and December 2015. Read More

    A Novel Method of Intraosseous Infusion of Adenosine for the Treatment of Supraventricular Tachycardia in an Infant.
    Pediatr Emerg Care 2017 Jan;33(1):47-48
    From the Departments of Paediatrics and Medicine, Schulich School of Medicine at Western University, Children's Hospital at London Health Sciences Centre, London, Ontario, Canada.
    Supraventricular tachycardia is a common arrhythmia faced by emergency physicians in the pediatric population. In most cases, antecubital intravenous access can be established, and adenosine can be administered in a rapid and timely fashion. The role and administration of intraosseous adenosine are poorly established. Read More

    Bent Metal in a Bone: A Rare Complication of an Emergent Procedure or a Deficiency in Skill Set?
    Case Rep Crit Care 2016 27;2016:4382481. Epub 2016 Nov 27.
    Department of Pulmonary and Critical Care, CHI Creighton University Medical Center, Omaha, NE, USA.
    Intraosseous (IO) access is an important consideration in patients with difficult intravenous (IV) access in emergent situations. IO access in adults has become more popular due to the ease of placement and high success rates. The most common sites of access include the proximal tibia and the humeral head. Read More

    Analysis of intraosseous blood samples using an EPOC point of care analyzer during resuscitation.
    Am J Emerg Med 2017 Mar 12;35(3):499-501. Epub 2016 Dec 12.
    Emergency Medicine, UCSF Fresno, United States. Electronic address:
    Background: In the early phases of resuscitation in a critically ill patient, especially those in cardiac arrest, intravenous (IV) access can be difficult to obtain. Intraosseous (IO) access is often used in these critical situations to allow medication administration. When no IV access is available, it is difficult to obtain blood for point of care analysis, yet this information can be crucial in directing the resuscitation. Read More

    Alternative Access Routes for Fluid Resuscitation.
    Top Companion Anim Med 2016 Jun 30;31(2):61-67. Epub 2016 Aug 30.
    Purdue University Intensive Care Unit and Emergency Service Supervisor, West Lafayette, IN, USA. Electronic address:
    Fluid resuscitation in small animals is important in emergency situations and is utilized by every veterinary practice. Peripherally inserted intravenous catheters are an effective way of giving fluids to a veterinary patient. If an intravenous catheter is not obtainable, there are multiple other ways to administer fluids to a patient including dorsal pedal catheters, intraosseous catheters, central venous catheters, peripherally inserted central catheters, nasogastric tubes, nasoesophageal tubes and subcutaneous administration of fluids. Read More

    A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings.
    J Vis Exp 2016 Nov 9(117). Epub 2016 Nov 9.
    Department of Emergency Medicine, Advocate Christ Medical Center;
    The available routes of administration commonly used for medications and fluids in the acute care setting are generally limited to oral, intravenous, or intraosseous routes, but in many patients, particularly in the emergency or critical care settings, these routes are often unavailable or time-consuming to access. A novel device is now available that offers an easy route for administration of medications or fluids via rectal mucosal absorption (also referred to as proctoclysis in the case of fluid administration and subsequent absorption). Although originally intended for the palliative care market, the utility of this device in the emergency setting has recently been described. Read More

    Comparison of Two Intraosseous Devices: The NIO Versus the EZ-IO by Novice Users-A Randomized Cross Over Trial.
    Prehosp Emerg Care 2017 May-Jun;21(3):315-321. Epub 2016 Nov 21.
    Background: During resuscitation in the field, intraosseous (IO) access may be achieved using a variety of available devices, often attempted by inexperienced users.

    Aim: We sought to examine the success rate and ease-of-use ratings of an IO device, the NIO® (New Intraosseous Persys Medical, Houston, TX, USA) in comparison to the Arrow® EZ-IO® (Teleflex Medical Research Triangle Park, NC, USA) by novice users.

    Methods: We performed a randomized crossover trial. Read More

    Analysis of thromboelastography, PT, APTT and fibrinogen in intraosseous and venous samples-an experimental study.
    Scand J Trauma Resusc Emerg Med 2016 Nov 3;24(1):131. Epub 2016 Nov 3.
    Clinical Chemistry, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
    Background: Laboratory analysis of coagulation is often important in emergencies. If vascular access is challenging, intraosseous catheterization may be necessary for treatment. We studied the analysis of coagulation parameters in intraosseous aspirate during stable conditions and after major haemorrhage in a porcine model. Read More

    Intraosseous Infusion as a Bridge to Definitive Access.
    Am Surg 2016 Oct;82(10):876-880
    Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
    Intraosseous (IO) needle placement is an alternative for patients with difficult venous access. The purpose of this retrospective study was to examine indications and outcomes associated with IO use at a Level 1 trauma center (January 2008-May 2015). Data points included demographics, time to insertion, intravenous (IV) access points, indications, infusions, hospital and intensive care unit length of stay, and mortality. Read More

    Evaluation of intraosseous sampling for measurements of alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase, creatinine kinase, gamma-glutamyl transferase and lactate dehydrogenase.
    Scand J Clin Lab Invest 2016 Dec 29;76(8):597-600. Epub 2016 Sep 29.
    b Section of Clinical Chemistry, Department of Medical Sciences , Uppsala University , Uppsala , Sweden.
    Background: Intraosseous (IO) access can be established faster than a venous or arterial access when there is an urgent need for rapid initiation of treatment. The access can also be used to draw marrow samples. The aim of the present study was to evaluate the potential use of IO samples for enzyme determinations using a porcine model. Read More

    Use of intraosseous devices in trauma: a survey of trauma practitioners in Canada, Australia and New Zealand.
    Can J Surg 2016 Dec;59(6):374-382
    From the Department of Surgery, McMaster University, Hamilton, Ont. (Engels); Trauma Nova Scotia, Halifax, NS (Erdogan, Green); the Department of Surgery, University of Alberta, Edmonton, Alta. (Widder); the Department of Critical Care Medicine, Dalhousie University, Halifax, NS (Butler, Kureshi, Green); and the Alfred Hospital, Melbourne, Australia (Martin).
    Background: Although used primarily in the pediatric population for decades, the use of intraosseous (IO) devices in the resuscitation of severely injured adult trauma patients has recently become more commonplace. The objective of this study was to determine the experience level, beliefs and attitudes of trauma practitioners in Canada, Australia and New Zealand regarding the use of IO devices in adult trauma patients.

    Methods: We administered a web-based survey to all members of 4 national trauma and emergency medicine organizations in Canada, Australia and New Zealand. Read More

    Point-Of-Care Ultrasound Diagnosis of Intravascular Air After Lower Extremity Intraosseous Access.
    J Emerg Med 2016 Dec 9;51(6):680-683. Epub 2016 Sep 9.
    Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.
    Background: Vascular air embolism is a rare but potentially deadly phenomenon. Early diagnosis allows providers to initiate measures aimed at preventing further air entry, preventing the migration of air to the lungs, and mitigating the hemodynamic effects of pulmonary air embolism.

    Case Report: An emergency physician used point-of-care ultrasound to identify intravascular air before embolization to the pulmonary vasculature. Read More

    CT angiography of the chest and abdomen in an emergency patient via humeral intraosseous access.
    Emerg Radiol 2017 Feb 29;24(1):105-108. Epub 2016 Aug 29.
    Department of Radiology, Charité-University Medicine Berlin, Berlin, Germany.
    A 69-year-old woman was taken to our emergency department after having been found unconscious. An intraosseous catheter was placed in the head of the right humerus due to inaccessible peripheral veins. With the suspected diagnosis of shock, pulmonary embolism, and mesenteric ischemia, a CT scan of the chest and abdomen was initiated. Read More

    Evidence on Adrenaline Use in Resuscitation and Its Relevance to Newborn Infants: A Non-Systematic Review.
    Neonatology 2017 13;111(1):37-44. Epub 2016 Aug 13.
    Centre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, Alta., Canada.
    Aim: Guidelines for newborn resuscitation state that if the heart rate does not increase despite adequate ventilation and chest compressions, adrenaline administration should be considered. However, controversy exists around the safety and effectiveness of adrenaline in newborn resuscitation. The aim of this review was to summarise a selection of the current knowledge about adrenaline during resuscitation and evaluate its relevance to newborn infants. Read More

    Adult Intraosseous Access by Advanced EMTs: A Statewide Non-Inferiority Study.
    Prehosp Emerg Care 2017 Jan-Feb;21(1):7-13. Epub 2016 Aug 5.
    Objective: Intraosseous (IO) access is increasingly being used as an alternative to peripheral intravenous access, which is often difficult or impossible to establish in critically ill patients in the prehospital setting. Until recently, only Paramedics performed adult IO access. In 2014, Vermont Emergency Medical Services (EMS) expanded the Advanced Emergency Medical Technicians (AEMTs) scope of practice to include IO access in adult patients. Read More

    [Case Report - Bilateral humeral intraosseous access for CPR in a 3-years-old child].
    Anasthesiol Intensivmed Notfallmed Schmerzther 2016 Jul 1;51(7-08):468-74. Epub 2016 Aug 1.
    Abteilung für Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie, Asklepios Klinikum Harburg, Hamburg.
    On-scene invasive emergency procedures, such as intraosseous puncture, are often unavoidable, when indicated, and present a challenge for the emergency physician. Personal, temporal or local conditions are often unsuitable. Even with regular intervention by the emergency medical service, "last resort" measures occur very infrequently, particularly in pediatric emergencies. Read More

    Single treatment of VX poisoned guinea pigs with the phosphotriesterase mutant C23AL: Intraosseous versus intravenous injection.
    Toxicol Lett 2016 Sep 7;258:198-206. Epub 2016 Jul 7.
    Bundeswehr Institute of Pharmacology and Toxicology, Munich, Germany.
    The recent attacks with the nerve agent sarin in Syria reveal the necessity of effective countermeasures against highly toxic organophosphorus compounds. Multiple studies provide evidence that a rapid onset of antidotal therapy might be life-saving but current standard antidotal protocols comprising reactivators and competitive muscarinic antagonists show a limited efficacy for several nerve agents. We here set out to test the newly developed phosphotriesterase (PTE) mutant C23AL by intravenous (i. Read More

    Intraosseous access in the obese patient: assessing the need for extended needle length.
    Am J Emerg Med 2016 Sep 15;34(9):1831-4. Epub 2016 Jun 15.
    MetroHealth Medical Center, Cleveland, OH.
    Background: Intraosseous (IO) access can be complicated by obesity. Successful placement of a 25 mm IO needle is unlikely when soft tissue depth exceeds 20 mm.

    Objectives: The authors examined the relationship between body mass index (BMI), the ability to palpate the tibial tuberosity (TT), and soft tissue depth at recommended IO insertion sites. Read More

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