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Complication with Intraosseous Access: Scandinavian Users’ Experience

INTRODUCTION: Intraosseous access (IO) is indicated if vascular access cannot be quickly established during resuscitation. Complication rates are estimated to be low, based on small patient series, model or cadaver studies, and case reports. However, user experience with IO use in real-life emergenc...

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Autores principales: Hallas, Peter, Brabrand, Mikkel, Folkestad, Lars
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Department of Emergency Medicine, University of California, Irvine School of Medicine 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3789903/
https://www.ncbi.nlm.nih.gov/pubmed/24106537
http://dx.doi.org/10.5811/westjem.2013.1.12000
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author Hallas, Peter
Brabrand, Mikkel
Folkestad, Lars
author_facet Hallas, Peter
Brabrand, Mikkel
Folkestad, Lars
author_sort Hallas, Peter
collection PubMed
description INTRODUCTION: Intraosseous access (IO) is indicated if vascular access cannot be quickly established during resuscitation. Complication rates are estimated to be low, based on small patient series, model or cadaver studies, and case reports. However, user experience with IO use in real-life emergency situations might differ from the results in the controlled environment of model studies and small patient series. We performed a survey of IO use in real-life emergency situations to assess users’ experiences of complications. METHODS: An online questionnaire was sent to Scandinavian emergency physicians, anesthesiologists and pediatricians. RESULTS: 1,802 clinical cases of IO use was reported by n=386 responders. Commonly reported complications with establishing IO access were patient discomfort/pain (7.1%), difficulties with penetration of periosteum with IO needle (10.3%), difficulties with aspiration of bone marrow (12.3%), and bended/broken needle (4.0%). When using an established IO access the reported complications were difficulties with injection fluid and drugs after IO insertion (7.4%), slow infusion (despite use of pressure bag) (8.8%), displacement after insertion (8.5%), and extravasation (3.7%). Compartment syndrome and osteomyelitis occurred in 0.6% and 0.4% of cases respectively. CONCLUSION: In users’ recollection of real-life IO use, perceived complications were more frequent than usually reported from model studies. The perceived difficulties with using IO could affect the willingness of medical staff to use IO. Therefore, user experience should be addressed both in education of how to use, and research and development of IOs.
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spelling pubmed-37899032013-10-08 Complication with Intraosseous Access: Scandinavian Users’ Experience Hallas, Peter Brabrand, Mikkel Folkestad, Lars West J Emerg Med Diagnostic Acumen INTRODUCTION: Intraosseous access (IO) is indicated if vascular access cannot be quickly established during resuscitation. Complication rates are estimated to be low, based on small patient series, model or cadaver studies, and case reports. However, user experience with IO use in real-life emergency situations might differ from the results in the controlled environment of model studies and small patient series. We performed a survey of IO use in real-life emergency situations to assess users’ experiences of complications. METHODS: An online questionnaire was sent to Scandinavian emergency physicians, anesthesiologists and pediatricians. RESULTS: 1,802 clinical cases of IO use was reported by n=386 responders. Commonly reported complications with establishing IO access were patient discomfort/pain (7.1%), difficulties with penetration of periosteum with IO needle (10.3%), difficulties with aspiration of bone marrow (12.3%), and bended/broken needle (4.0%). When using an established IO access the reported complications were difficulties with injection fluid and drugs after IO insertion (7.4%), slow infusion (despite use of pressure bag) (8.8%), displacement after insertion (8.5%), and extravasation (3.7%). Compartment syndrome and osteomyelitis occurred in 0.6% and 0.4% of cases respectively. CONCLUSION: In users’ recollection of real-life IO use, perceived complications were more frequent than usually reported from model studies. The perceived difficulties with using IO could affect the willingness of medical staff to use IO. Therefore, user experience should be addressed both in education of how to use, and research and development of IOs. Department of Emergency Medicine, University of California, Irvine School of Medicine 2013-09 /pmc/articles/PMC3789903/ /pubmed/24106537 http://dx.doi.org/10.5811/westjem.2013.1.12000 Text en Copyright © 2013 the authors. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) License. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Diagnostic Acumen
Hallas, Peter
Brabrand, Mikkel
Folkestad, Lars
Complication with Intraosseous Access: Scandinavian Users’ Experience
title Complication with Intraosseous Access: Scandinavian Users’ Experience
title_full Complication with Intraosseous Access: Scandinavian Users’ Experience
title_fullStr Complication with Intraosseous Access: Scandinavian Users’ Experience
title_full_unstemmed Complication with Intraosseous Access: Scandinavian Users’ Experience
title_short Complication with Intraosseous Access: Scandinavian Users’ Experience
title_sort complication with intraosseous access: scandinavian users’ experience
topic Diagnostic Acumen
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3789903/
https://www.ncbi.nlm.nih.gov/pubmed/24106537
http://dx.doi.org/10.5811/westjem.2013.1.12000
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