Intraosseous infusion using the bone injection gun in the prehospital setting

Resuscitation ◽  
2009 ◽  
Vol 80 (3) ◽  
pp. 384-385 ◽  
Author(s):  
Jean-Stephane David ◽  
Pierre-Yves Dubien ◽  
Olivier Capel ◽  
Olivier Peguet ◽  
Pierre-Yves Gueugniaud
Keyword(s):  
Prehospital Setting ◽  
Intraosseous Infusion ◽  
Bone Injection

Prehospital Intraosseous Infusion by Emergency Medical Services Personnel: A Prospective Study

PEDIATRICS ◽  
1989 ◽  
Vol 84 (1) ◽  
pp. 173-177
Author(s):  
Robert S. Seigler ◽  
Fred W. Tecklenburg ◽  
Ralph Shealy
Keyword(s):  
Prospective Study ◽  
Emergency Medical Services ◽  
Pediatric Patients ◽  
Cardiopulmonary Arrest ◽  
Prehospital Setting ◽  
Intraosseous Access ◽  
Intraosseous Infusion ◽  
Emergency Medical Services Personnel ◽  
A Prospective Study ◽  
Infusion Technique

Intraosseous infusion technique by paramedics in the prehospital setting was prospectively evaluated. Intraosseous access was successfully established in 16 of 17 pediatric patients with cardiopulmonary arrest. There were 13 successful first attempts with intraosseous access established within 1 minute. No significant complications occurred. In this study, the ease of establishing intraosseous access by paramedics in the field is documented.

Intraosseous infusion systems in the prehospital setting

Resuscitation ◽  
2009 ◽  
Vol 80 (5) ◽  
pp. 607 ◽  
Author(s):  
Thorsten Brenner ◽  
André Gries ◽  
Matthias Helm ◽  
Michael Bernhard
Keyword(s):  
Prehospital Setting ◽  
Intraosseous Infusion ◽  
Infusion Systems

Intraosseous Access in the Prehospital Setting: Literature Review

2012 ◽  
Vol 27 (5) ◽  
pp. 468-472 ◽  
Author(s):  
Alexander Olaussen ◽  
Brett Williams
Keyword(s):  
Literature Review ◽  
Skill Acquisition ◽  
Vascular System ◽  
Grey Literature ◽  
National Level ◽  
Prehospital Setting ◽  
Inclusion Criteria ◽  
Intraosseous Access ◽  
Simple Method ◽  
Intraosseous Infusion

AbstractBackgroundAlthough 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.ObjectivesReview the literature regarding the use of intraosseous (IO) devices in the prehospital setting.MethodsSelected 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.FindingsThe 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.ConclusionWhile 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.OlaussenA, WilliamsB. Intraosseous access in the prehospital setting: literature review. Prehosp Disaster Med.2012;27(5):1-5.

scholarly journals Prehospital characteristics of COVID-19 patients in Helsinki – experience of the first wave of the pandemic

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Markku Kuisma ◽  
Heini Harve-Rytsälä ◽  
Jussi Pirneskoski ◽  
James Boyd ◽  
Mitja Lääperi ◽  
...  
Keyword(s):  
Foreign Language ◽  
World Health Organisation ◽  
Prehospital Setting ◽  
Tympanic Temperature ◽  
World Health ◽  
Who Criteria ◽  
Laboratory Confirmation ◽  
Patient Groups ◽  
Mode Of Transportation ◽  
Time Urgency

Abstract Background There is a lack of knowledge how patients with COVID-19 disease differ from patients with similar signs or symptoms (but who will have a diagnosis other than COVID-19) in the prehospital setting. The aim of this study was to compare the characteristics of these two patient groups met by the emergency medical services. Methods All prehospital patients after the World Health Organisation (WHO) pandemic declaration 11.3.2020 until 30.6.2020 were recruited for the study. The patients were screened using modified WHO criteria for suspected COVID-19. Data from the electronic prehospital patient reporting system were linked with hospital laboratory results to check the laboratory confirmation for COVID-19. For comparison, we divided the patients into two groups: screening- and laboratory-positive patients with a hospital diagnosis of COVID-19 and screening-positive but laboratory-negative patients who eventually received a different diagnosis in hospital. Results A total of 4157 prehospital patients fulfilled the criteria for suspected COVID-19 infection during the study period. Five-hundred-thirty-six (12.9%) of the suspected cases received a laboratory confirmation for COVID-19. The proportion of positive cases in relation to suspected ones peaked during the first 2 weeks after the declaration of the pandemic. In the comparison of laboratory-positive and laboratory-negative cases, there were clinically insignificant differences between the groups in age, tympanic temperature, systolic blood pressure, heart rate, on-scene time, urgency category of the call and mode of transportation. Foreign-language-speakers were overrepresented amongst the positive cases over native language speakers (26,6% vs. 7,4%, p < 0,001). The number of cases in which no signs or symptoms of COVID-19 disease were reported, but patients turned out to have a positive test result was 125 (0,3% of the whole EMS patient population and 11,9% of all verified COVID-19 patients encountered by the EMS). Conclusions In a sample of suspected COVID-19 patients, the laboratory-positive and laboratory-negative patients were clinically indistinguishable from each other during the prehospital assessment. Foreign-language-speakers had a high likelihood of having Covid-19. The modified WHO criteria still form the basis of screening of suspected COVID-19 patients in the prehospital setting.

scholarly journals Efficacy of tracheal tube introducers and stylets for endotracheal intubation in the prehospital setting: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Jaden Tollman ◽  
Zubair Ahmed
Keyword(s):  
Systematic Review ◽  
Endotracheal Intubation ◽  
Tracheal Tube ◽  
Meta Analysis ◽  
Prehospital Setting ◽  
Cochrane Central Register ◽  
Success Rates ◽  
Video Technology ◽  
Summary Estimate ◽  
First Pass

Abstract Purpose Tracheal tube introducers and stylets remain some of the most widely used devices for aiding practitioners in performing endotracheal intubation (ETI). The purpose of this systematic review is to evaluate the efficacy of tracheal tube introducers and stylets for ETI in the prehospital setting. Methods A literature search was conducted on the 2nd of March 2021 across PubMed, Embase (Ovid) and the Cochrane Central Register of Controlled Trials (CENTRAL) to identify relevant studies. Included studies had their data extracted and both a quality assessment and statistical analysis were performed. Results The summary estimate of prehospital studies with video technology showed a statistically significant increase in first pass ETI success in favour of bougies (RR 1.15, CI 1.10–1.21, p < 0.0001). The summary estimates of prehospital studies without video technology and simulation studies with and without video technology showed no statistical difference between methods for first pass or overall ETI success. Some of the highest success rates were recorded by devices that incorporated video technology. Stylets lead to a shorter time to ETI while bougies were easier to use. Neither device was associated with a higher rate of ETI complications than the other. Conclusion Both tracheal tube introducers and stylets function as efficacious aids to intubation in the prehospital environment. Where video technology is available, bougies could offer a statistically significant advantage in terms of first pass ETI success. Where video technology is unavailable, a combination of clinical scenario, practitioner expertise and personal preference might ultimately guide the choice of device.

Ready for Children Part II: Increasing Pediatric Care Coordination and Psychomotor Skills Evaluation in the Prehospital Setting

2021 ◽  
pp. 1-10
Author(s):  
Hilary A. Hewes ◽  
Andrea L. Genovesi ◽  
Rachel Codden ◽  
Michael Ely ◽  
Lorah Ludwig ◽  
...  
Keyword(s):  
Care Coordination ◽  
Prehospital Setting ◽  
Pediatric Care ◽  
Psychomotor Skills

Glucose as an additional parameter to National Early Warning Score (NEWS) in prehospital setting enhances identification of patients at risk of death: an observational cohort study

2020 ◽  
pp. emermed-2018-208309
Author(s):  
Hanna Vihonen ◽  
Mitja Lääperi ◽  
Markku Kuisma ◽  
Jussi Pirneskoski ◽  
Jouni Nurmi
Keyword(s):  
At Risk ◽  
Blood Glucose ◽  
Regression Model ◽  
Early Warning ◽  
Prehospital Setting ◽  
Early Warning Score ◽  
Calibration Model ◽  
Risk Of Death ◽  
Patients At Risk ◽  
National Early Warning Score

BackgroundTo determine if prehospital blood glucose could be added to National Early Warning Score (NEWS) for improved identification of risk of short-term mortality.MethodsRetrospective observational study (2008–2015) of adult patients seen by emergency medical services in Helsinki metropolitan area for whom all variables for calculation of NEWS and a blood glucose value were available. Survival of 24 hours and 30 days were determined. The NEWS parameters and glucose were tested by multivariate logistic regression model. Based on ORs we formed NEWSgluc model with hypoglycaemia (≤3.0 mmol/L) 3, normoglycaemia 0 and hyperglycaemia (≥11.1 mmol/L) 1 points. The scores from NEWS and NEWSgluc were compared using discrimination (area under the curve), calibration (Hosmer-Lemeshow test), likelihood ratio tests and reclassification (continuous net reclassification index (cNRI)).ResultsData of 27 141 patients were included in the study. Multivariable regression model for NEWSgluc parameters revealed a strong association with glucose disturbances and 24-hour and 30-day mortality. Likelihood ratios (LRs) for mortality at 24 hours using a cut-off point of 15 were for NEWSgluc: LR+ 17.78 and LR− 0.96 and for NEWS: LR+ 13.50 and LR− 0.92. Results were similar at 30 days. Risks per score point estimation and calibration model showed glucose added benefit to NEWS at 24 hours and at 30 days. Although areas under the curve were similar, reclassification test (cNRI) showed overall improvement of classification of survivors and non-survivors at 24 days and 30 days with NEWSgluc.ConclusionsIncluding glucose in NEWS in the prehospital setting seems to improve identification of patients at risk of death.

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