Clinical evaluation of intravenous alone versus intravenous or intraosseous access for treatment of out-of-hospital cardiac arrest.

Resuscitation
Boon Kiat Kenneth TanMarcus Eng Hock Ong

Abstract

Obtaining vascular access during out-of-hospital cardiac arrest (OHCA) is challenging. The aim of this study was to determine if using intraosseous (IO) access when intravenous (IV) access fails improves outcomes. This was a prospective, parallel-group, cluster-randomised study that compared 'IV only' against 'IV + IO' in OHCA patients, where if 2 IV attempts failed or took more than 90 s, paramedics had 2 further attempts of IO. Primary outcome was any return of spontaneous circulation (ROSC). Secondary outcomes were insertion success rate, adrenaline administration, time to adrenaline and survival outcome. A total of 1007 patients were included in the analysis. An Intention To Treat analysis showed a significant difference in success rates of obtaining vascular access in the IV + IO arm compared to the IV arm (76.6% vs 61.1% p = 0.001). There were significantly more patients in the IV + IO arm than the IV arm being administered prehospital adrenaline (71.3% vs 55.4% p = 0.001). The IV + IO arm also received adrenaline faster compared to the IV arm in terms of median time from emergency call to adrenaline (23 min vs 25 min p = 0.001). There was no significant difference in ROSC (adjusted OR 0.99 95%CI: 0.75-1.29), survival to ...Continue Reading

References

Oct 1, 1989·Annals of Emergency Medicine·F R La FlecheD P Milzman
Sep 1, 1985·Annals of Emergency Medicine·V A RosettiC Aprahamian
Mar 1, 1994·The American Journal of Emergency Medicine·D S Katz, A R Wojtowycz
Mar 1, 1993·The Journal of Bone and Joint Surgery. American Volume·T Burke, D K Kehl
Oct 21, 2003·The Journal of Trauma·Douglas M G BowleyGraeme J Pitcher
Apr 25, 2007·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Ralph J FrasconeJoshua G Salzman
Feb 6, 2008·Emergency Radiology·R R van RijnB Kubat
Dec 2, 2008·The American Journal of Emergency Medicine·Marcus Eng Hock OngAdeline Su-Yin Ngo
Feb 1, 2011·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Rosalyn ReadesTom Blackwell
May 31, 2011·BMJ : British Medical Journal·Colm C Taylor, N M P Clarke
Oct 28, 2011·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Richard SchalkChristian Byhahn
Jan 17, 2012·The American Journal of Emergency Medicine·Boon Kiat Kenneth TanMarcus Eng Hock Ong
Apr 7, 2012·Circulation Journal : Official Journal of the Japanese Circulation Society·Yasuyuki HayashiTatsuro Kai
Jul 19, 2012·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Shinji NakaharaTetsuya Sakamoto
Jun 4, 2014·Pediatric Emergency Care·Gorm Erlend OesterlieTine Brink Henriksen
Oct 20, 2015·Resuscitation·Ian K MaconochieUNKNOWN Paediatric life support section Collaborators
Mar 8, 2018·Circulation·Matthew HansenUNKNOWN Resuscitation Outcomes Consortium Investigators
May 29, 2018·The American Journal of Emergency Medicine·Yosuke HommaUNKNOWN SOS-KANTO 2012 Study Group

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