Paramedics successfully perform humeral EZ-IO intraosseous access in adult out-of-hospital cardiac arrest patients
| Autor: | Robert Beckett, Joi Shumaker, Scotty Bolleter, Craig A Manifold, Daniel Schwartz, David A. Wampler |
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| Rok vydání: | 2012 |
| Předmět: |
Male
Emergency Medical Services medicine.medical_specialty Proximal humerus Vascular access Out of hospital cardiac arrest Primary outcome Humans Medicine Humerus Retrospective Studies business.industry Retrospective cohort study Mean age General Medicine Middle Aged Infusions Intraosseous Cardiopulmonary Resuscitation Surgery Emergency Medical Technicians medicine.anatomical_structure Cohort Emergency Medicine Female business Out-of-Hospital Cardiac Arrest |
| Zdroj: | The American Journal of Emergency Medicine. 30:1095-1099 |
| ISSN: | 0735-6757 |
| DOI: | 10.1016/j.ajem.2011.07.010 |
| Popis: | Objective Studies on humeral placement of the EZ-IO (Vidacare, Shavano Park, TX, USA) have shown mixed results. We performed a study to determine the first-attempt success rate at humeral placement of the EZ-IO by paramedics among prehospital adult cardiac arrest patients. Methods A retrospective cohort analysis of data prospectively collected over a 9-month period. Data are a subset extracted from a prehospital cardiac arrest study. The cohort consisted of adult cardiac arrest patients in whom the EZ-IO placement was attempted in the humerus by paramedics. Choice of vascular access was at the discretion of the paramedic; options included tibial or humeral EZ-IO and intravenous. Primary outcome is the percentage of successful placements (stable, flow, without extravasation) on first attempt. Secondary outcomes are overall successful placement, complications, and reason for failure. Data were collected during a post–cardiac arrest interview. Results Humeral intraosseous (IO) access was attempted in 61% (n = 247) of 405 cardiac arrests evaluated with mean age of 63 (±16) years, 58% male. First-attempt successful placement was 91%. Successful placement was 94%, considering the second attempts. In the unsuccessful attempts, 2% reported obesity as the cause, 1% reported stable placement without flow, and 2% reported undocumented causes for failure. There were also 2% reports of successful placement with subsequent dislodgement. Conclusions The results of this study suggest a high degree of paramedic proficiency in establishment of IO access in the proximal humerus of the out-of-hospital cardiac arrest. Few complications suggest that proximal humeral IO access is a reliable method for vascular access in this patient population. |
| Databáze: | OpenAIRE |
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