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Intraosseous Access in the Prehospital Setting: Literature Review.
MedLine Citation:
PMID:  22877834     Owner:  NLM     Status:  Publisher    
BACKGROUND: Although the majority of Australian intensive care paramedics use the manual intraosseous infusion technique (MAN-IO), several other semiautomatic devices now are available, such as the bone injection gun (BIG) and the semiautomatic intraosseous infusion system (EZ-IO). Given the choice of devices now available, questions have been raised regarding success rates, accuracy, decay of skills, and adverse events. OBJECTIVES: Review the literature regarding the use of intraosseous (IO) devices in the prehospital setting. METHODS: Selected electronic databases (Medline, Embase, and CINAHL) were searched, and a hand search was conducted for grey-literature that included studies from the commencement of the process to the end of May 2010. Inclusion criteria were any study reporting intraosseous insertion and/or infusion (adult and pediatric) by paramedics in the prehospital setting. Findings The search located 2,100 articles; 20 articles met the inclusion criteria. The review also noted that use of IO access (regardless of technique) offers a safe and simple method for gaining access to the patients' vascular system. A number of studies found that the use of semiautomatic devices offers better and faster intraosseous access compared with the use of manual devices, and also were associated with fewer complications. The findings also suggest that the use of semiautomatic devices can reduce insertion times and the number of insertion attempts when contrasted with the use of manual insertion techniques. Despite these findings, statistically no specific IO device has proven clinical superiority. Conclusion While manual IO techniques currently are used by the majority of Australian paramedics, the currently available evidence suggests that semiautomatic devices are more effective. Further research, including cost-benefit analyses, is required at a national level to examine skill acquisition, adverse effects, and whether comparative devices offer clinically significant advantages. Olaussen A, Williams B. Intraosseous access in the prehospital setting: literature review. Prehosp Disaster Med. 2012;27(5):1-5.
Alexander Olaussen; Brett Williams
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-9
Journal Detail:
Title:  Prehospital and disaster medicine     Volume:  -     ISSN:  1049-023X     ISO Abbreviation:  Prehosp Disaster Med     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8918173     Medline TA:  Prehosp Disaster Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  1-5     Citation Subset:  -    
School of Primary Health Care, Monash University-Peninsula Campus, Frankston, Victoria, Australia.
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