Department of Surgery-Traumatology, Erasmus Medical Center, Rotterdam, The Netherlands.
Prehosp Emerg Care. 2010 Jan-Mar;14(1):6-13. doi: 10.3109/10903120903349861.
Access to the circulation is mandatory for adequate treatment in medical emergency situations. Intraosseous (IO) infusion is a safe, fast, and effective alternative for gaining access to the circulation, if intravenous access fails. In the last decade, the IO method gained renewed interest. New devices have been developed, such as the Bone Injection Gun (BIG) 15G/18G and the First Access for Shock and Trauma 1 (FAST1).
To determine which IO needle is preferable for gaining IO access in patients requiring acute administration of fluids or medication in a prehospital setting.
In this single-blind prospective randomized trial, the IO needles were added to the equipment of the helicopter emergency medical services (HEMS) system. The HEMS nurses received training in proper use of all needles. Children (1-13 years) were randomized to the Jamshidi 15G or the BIG 18G, and adults (>or= 14 years) were randomized to the Jamshidi 15G, the BIG 15G, or the FAST1. All patients requiring acute administration of fluids or medication, without successful insertion of an intravenous (IV) catheter, were included. The IO needles were compared in terms of insertion time, success rate, bone marrow aspiration, adverse events during placement, and user satisfaction.
Sixty-five adult and 22 pediatric patients were included. The treatment groups were similar with respect to age, gender, mortality, and trauma mechanism (p >or= 0.05). The median insertion times ranged from 38 seconds for the Jamshidi 15G to 49 seconds for the BIG 15G and 62 seconds for the FAST1 (p = 0.004). The devices did not differ with respect to success rates (adults overall 80% and children overall 86%), complication rates, and user satisfaction.
The Jamshidi 15G needle could be placed significantly faster than the FAST1. The devices had similar success rates, complication rates, and user-friendliness. Intraosseous devices provide a safe, simple, and fast method for gaining access to the circulation in emergency situations.
在医疗急救情况下，进入循环系统是充分治疗的必要条件。如果静脉通路建立失败，骨髓内（IO）输注是一种安全、快速且有效的替代方法。在过去十年中，IO 方法重新受到关注。已经开发了新的设备，例如 Bone Injection Gun（BIG）15G/18G 和 First Access for Shock and Trauma 1（FAST1）。
确定在需要在院前环境中急性给予液体或药物的患者中，哪种 IO 针更适合获得 IO 通路。
在这项单盲前瞻性随机试验中，IO 针被添加到直升机紧急医疗服务（HEMS）系统的设备中。HEMS 护士接受了正确使用所有针的培训。将儿童（1-13 岁）随机分为 Jamshidi 15G 或 BIG 18G，成人（> = 14 岁）随机分为 Jamshidi 15G、BIG 15G 或 FAST1。所有需要急性给予液体或药物但静脉（IV）导管插入不成功的患者均被纳入研究。比较了 IO 针的插入时间、成功率、骨髓抽吸、放置过程中的不良事件和用户满意度。
纳入 65 例成人和 22 例儿科患者。治疗组在年龄、性别、死亡率和创伤机制方面相似（p> = 0.05）。插入时间中位数范围从 Jamshidi 15G 的 38 秒到 BIG 15G 的 49 秒和 FAST1 的 62 秒（p = 0.004）。这些设备在成功率（成人总体为 80%，儿童总体为 86%）、并发症发生率和用户满意度方面没有差异。
Jamshidi 15G 针的插入速度明显快于 FAST1。这些设备具有相似的成功率、并发症发生率和用户友好性。IO 设备为在紧急情况下获得循环通路提供了一种安全、简单且快速的方法。
