Author:
Ohchi Fumihiro,Komasawa Nobuyasu,Mihara Ryosuke,Minami Toshiaki
Abstract
Abstract
Background
During resuscitation, when it is difficult or impossible to establish peripheral venous access, intraosseous route (IO) is considered as an alternative to a central venous line. However, it is sometimes difficult for obtain IO access with conventional manual bone puncture needle. Recently, powered mechanical bone marrow needle was developed. We compared the performance of the manual and mechanical bone marrow puncture needle for adult, child and infant simulation.
Methods
22 anesthesiologists, who has never used bone marrow puncture needle, performed manual (Dickman™, Cook Medical) or mechanical (EZ-IO™, Teleflex) bone marrow puncture to simulated adult, child and infant tibia. Puncture success rate, insertion time, and subjective difficulty utilizing visual analogue scale was assessed.
Results
In adult settings, with the manual bone marrow needle, only 3 of 22 participants could succeed in the IO route keep, while all participants did in the mechanical bone marrow puncture needle (P < 0.001). In child and infant settings, all trials were successful in both manual and mechanical bone marrow puncture needles (P = 1.00). In adult simulations, IO insertion took significantly longer with manual bone marrow puncture (54.8 ± 15.8 s) than without compressions (3.7 ± 2.1 s; P < 0.001). In child and infant simulations, the IO insertion time was significantly smaller in mechanical trials than in manual ones (child simulation; manual 9.3 ± 4.6 s, mechanical 2.2 ± 0.8 s, P < 0.001, infant simulation; manual 2.0 ± 1.1 s, mechanical 1.5 ± 0.8 s, P = 0.003).
Although the VAS score was not significantly higher with manual trials than in mechanical trials among the three simulations (adult simulation, P < 0.001, child simulation, P < 0.001, infant simulation P = 0.006).
Conclusions
We conclude that in simulations managed by anesthesiologists who had no clinical experiences with bone marrow puncture, the mechanical bone puncture needle performed better than the manual one for emergency IO route access.
Publisher
Springer Science and Business Media LLC
Reference21 articles.
1. Banerjee S, Singhi SC, Singh S, Singh M (1994) The intraosseous route is a suitable alternative to intravenous route for fluid resuscitation in severely dehydrated children. Indian Pediatr 31:1511–1520
2. Blumberg SM, Gorn M, Crain EF (2008) Intraosseous infusion: a review of methods and novel devices. Pediatr Emerg Care 24:50–6
3. Cooper BR, Mahoney PF, Hodgetts TJ, Mellor A (2007) Intra-osseous access (EZ-IO) for resuscitation:UK military combat experience. J R Army Med Corps 153:314–6
4. Deakin CD, Nolan JP, Soar J, Sunde K, Koster RW, Smith GB, Perkins GD (2010) European Resuscitation Council Guidelines for Resuscitation 2010 Section 4. Adult advanced life support. Resuscitation 81:1305–1352
5. Dorian P, Cass D, Schwartz B, Cooper R, Gelaznikas R, Barr A (2002) Amiodarone as compared with lidocaine for shock-resistant ventricular fibrillation. N Engl J Med 346:884–890
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