Powered Intraosseous Insertion Provides Safe and Effective Vascular Access for Pediatric Emergency Patients
- 1 June 2008
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Pediatric Emergency Care
- Vol. 24 (6), 347-350
- https://doi.org/10.1097/pec.0b013e318177a6fe
Abstract
For decades, intraosseous (IO) access has been a standard of care for pediatric emergencies in the absence of conventional intravenous access. After the recent introduction of a battery-powered IO insertion device (EZ-IO; Vidacare Corporation, San Antonio, TX), it was recognized that a clinical study was needed to demonstrate device safety and effectiveness for pediatric patients. We measured the insertion success rate, patient pain levels during insertion and infusion, insertion time, types of fluid and drugs administered, device ease of use on a scale of 1 (easy) to 5 (difficult), and complications. There were 95 eligible patients in the study; 56% were males. Mean patient age was 5.5 +/- 6.1 years. Successful insertion and infusion was achieved in 94% of the patients. Insertion time was 10 seconds or less in 77% of the one-attempt successful cases reporting time to insertion. There were 4 minor complications (4%), but none significant. For patients with a Glasgow Coma Scale (GCS) score >8, mean insertion pain score was 2.3 +/- 2.8, and mean infusion pain score was 3.2 +/- 3.5. The device was rated easy to use 71% of the time (n = 49) and the mean score was 1.4. The results of this study support the use of the powered IO insertion device for fluid and drug delivery to children in emergency situations. The rare and minor complications suggest that the powered IO device is a safe and effective means of achieving vascular access in the resuscitation and stabilization of pediatric patients.Keywords
This publication has 14 references indexed in Scilit:
- Intraosseous puncture in preclinical emergency medicineDer Anaesthesist, 2007
- Consecutive Field Trials Using Two Different Intraosseous DevicesPrehospital Emergency Care, 2007
- Time to give the first medication during resuscitation in out-of-hospital cardiac arrestResuscitation, 2006
- The utilisation of intraosseous infusion in the resuscitation of paediatric major trauma patientsInjury, 2005
- Intraosseous access in the setting of pediatric critical care transportPediatric Critical Care Medicine, 2005
- Tibial fracture: A complication of intraosseous infusionThe American Journal of Emergency Medicine, 1994
- Five-year experience in prehospital intraosseous infusions in children and adultsAnnals of Emergency Medicine, 1993
- The effects of intraosseous infusion on the growth plate in a nestling rabbit modelAnnals of Emergency Medicine, 1992
- Intraosseous infusion: An alternative route of pediatric intravascular accessAnnals of Emergency Medicine, 1985
- Bone marrow infusion in childhood: Experiences from a thousand infusionsThe Journal of Pediatrics, 1947