Intraosseous versus central venous catheter utilization and performance during inpatient medical emergencies

Critical Care Medicine
Peter M J LeeSamuel Acquah

Abstract

Intraosseous access is a rapid and effective route of fluid and drug administration. Its use has been proven in emergency medicine, pediatrics, and the military. We aimed to assess its performance and utilization against landmark-guided central venous catheter placement during inpatient medical emergencies. Prospective observational study. Eight hundred fifty-six-bed urban teaching hospital. Adult inpatients requiring central venous access during medical emergencies. Intraosseous device training was added to standard central venous catheter training beginning in February 2012. Intraosseous were used as primary access in cardiac arrests and secondary access if central venous catheter placement failed during noncardiac arrest emergencies. An online survey was conducted among intraosseous and central venous catheter operators to assess their experience and any barriers to use. Seventy-nine adults had central access placement from February 2012 to July 2013. Sixty were during medical emergency team calls, and 19 were cardiac arrests. Thirty-one received intraosseous device, and 48 received a central venous catheter. First-pass success was significantly higher for intraosseous than for central venous catheter (90.3 vs 37.5%; 95% CI,...Continue Reading

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Nov 26, 2015·The Journal of Emergency Medicine·Jamie K Overbey, Alexander A Kon
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