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Emergency department utilization and success rates for intraosseous infusion in pediatric resuscitations

Published online by Cambridge University Press:  21 May 2015

Cheri Nijssen-Jordan
Cheri Nijssen-Jordan*
Affiliation:
Division of Pediatric Emergency Medicine, Alberta Children’s Hospital, and the University of Calgary, Calgary, Alta
*
cheri.nijssen-jordan@crha-health.ab.ca

Abstract

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Objective:

To determine the frequency of use and the success rates of intraosseous (IO) vascular access in the emergency department.

Design:

A retrospective chart review.

Setting:

A tertiary pediatric emergency department (ED) in a large urban centre.

Methods:

ED resuscitations (ICD-9 code 996) occurring between Oct. 1, 1989, and Sept. 30, 1995, were identified by searching the ED database, inpatient database, ICU admission log and provincial medical examiner’s database. From these, all cases involving IO access were selected and comprised the study sample. Demographics, diagnosis, number of IO attempts, success or failure of IO placement, relevant times and patient outcomes were recorded on standard data forms. Frequency of use, success rates and performance times were reported.

Results:

IO access was successful in 36 of 42 (86%) patients. In total, there were 68 attempts, or 1.6 attempts per child. All but one child were less than 3 years of age. The median time to successful IO placement was 8 minutes. Two complications, both fractures, occurred in one patient, a 10-day-old neonate.

Conclusions:

IO success rates were high despite infrequent use.

Keywords

intraosseouspediatricemergency departmentresuscitationinfusion
Type
Pediatrics • Pédiatrie
Information
Canadian Journal of Emergency Medicine , Volume 2 , Issue 1 , January 2000 , pp. 10 - 14
Copyright
Copyright © Canadian Association of Emergency Physicians 2000

References

1.Drinker, CK, Drinker, KR, Lund, CC.The circulation in the mammalian bone-marrow. Am J Physiol 1922;62:1–92.CrossRefGoogle Scholar
2.Josefson, A.A new method of treatment — intraossal injections. Acta Medica Scandinavica 1934; LXXXI:550–64.CrossRefGoogle Scholar
3.Tocantins, LM, O’Neill, JF.Infusion of blood and other fluids into the circulation via the bone marrow. Proceedings from the Society of Experimental Biology and Medicine 1940;45:782–3.CrossRefGoogle Scholar
4.Tocantins, LM, O’Neill, JF.Infusions of blood and other fluids into the general circulation via the bone marrow: techniques and results. Surg Gynecol Obst 1941;73:281–7.Google Scholar
5.Arbeiter, HI, Greengard, J.Tibial bone marrow infusion in infancy. J Pediatr 1944;25:1–16.CrossRefGoogle Scholar
6.Spivey, WH, Lathers, CM, Malone, DR, Unger, HD, Bhat, S, McNamara, RN, et al. Comparison of intraosseous, central and peripheral routes of sodium bicarbonate administration during CPR in pigs. Ann Emerg Med 1985;14:1135–40.CrossRefGoogle ScholarPubMed
7.Medina, FA.Rapid sequence induction/intubation using intraosseous infusion of vecuronium bromide in children. Am J Emerg Med 1992;10:359–60.CrossRefGoogle ScholarPubMed
8.Jennings, RW, Adzick, NS, Longaker, MT, Lorenz, HP, Estes, JM, Harrison, MR.New techniques in fetal surgery. J Pediatr Surg 1992;27:1329–33.CrossRefGoogle ScholarPubMed
9.Guy, J, Haley, K, Zuspan, SJ.Use of intraosseous infusion in the pediatric trauma patient. J Pediatr Surgery 1993;28:158–61.CrossRefGoogle ScholarPubMed
10.Chameides, L, editor. Pediatric advanced life support. Washington: American Heart Association/American Academy of Pediatrics; 1997.Google Scholar
11.Spivey, WH.Intraosseous infusions. J Pediatr 1987;111:639–43.CrossRefGoogle ScholarPubMed
12.Strange, G, editor. Advanced pediatric life support. The pediatric emergency medicine course. Washington: American Heart Association/American Academy of Pediatrics; 1998.Google Scholar
13.Glaeser, PW, Hellmich, TR, Szewczuga, D.Five-year experience in prehospital intraosseous infusions in children and adults. Ann Emerg Med 1993;22:1119–24.CrossRefGoogle ScholarPubMed
14.Kanter, RK, Zimmerman, JL, Strauss, RH, Stoeckel, KA.Pediatric emergency intravenous access: evaluation of a protocol. AJDC 1986;140:132–4.Google ScholarPubMed