Bielski Karol, Szarpak Lukasz, Smereka Jacek, Ladny Jerzy R, Leung Steve, Ruetzler Kurt
MEDITRANS The Voivodship Emergency Medical Service and Sanitary Transport, Warsaw, Poland.
Department of Emergency Medicine, Medical University of Warsaw, Lindleya 4 Street, 02-005, Warsaw, Poland.
Eur J Pediatr. 2017 Jul;176(7):865-871. doi: 10.1007/s00431-017-2922-z. Epub 2017 May 12.
The aim of the study was to compare the success rate, procedure time, and user satisfaction of pediatric NIO™ compared to Pediatric BIG®, EZ-IO®, and Jamshidi intraosseous access devices. This was a randomized, crossover manikin trial with 87 paramedics. The correct location of intraosseous access when using NIO, BIG, EZ-IO, and Jamshidi was varied and was respectively 100, 90, 90, and 90%. The time required to obtain intravascular access (time T1) in the case of NIO, BIG, EZ-IO, and Jamshidi was varied and amounted to 9 s [IQR, 8-12] for NIO, 12 s [IQR, 9-16] for BIG, 13.5 s [IQR, 11-17] for the EZ-IO, and 15 s [IQR, 13-19] for Jamshidi. The paramedics evaluated each device on the subjective ease with which they performed the procedures. The intraosseous device, which proved the easiest to use was NIO, which in the case of CPR received a median rating of 1.5 (IQR, 0.5-1.5) points.
Our study found that NIO® is superior to BIG®, EZ-IO®, and Jamshidi. NIO® achieved the highest first attempt success rate. NIO® also required the least time to insert and easiest to operate even by novice users. Further study is needed to test our findings in cadavers or human subjects. Based on our findings, NIO® is a promising intraosseous device for use in pediatric resuscitation. What is Known: • Venous access in acutely ill pediatric patients, such as those undergoing cardiopulmonary resuscitation, is needed for prompt administration of drugs and fluids. • Intraosseous access is recommended by American Heart Association and European Resuscitation council if vascular access is not readily obtainable to prevent delay in treatment. What is New: • This simulated pediatric resuscitation compared performance of four commercially available pediatric intraosseous devices in a manikin model. • NIO® outperformed BIG®, EZ-IO®, and Jamshidi in first attempt success rates and time of procedure among novice users.
本研究的目的是比较儿科NIO™与儿科BIG®、EZ-IO®和Jamshidi骨内穿刺装置的成功率、操作时间和用户满意度。这是一项针对87名护理人员的随机交叉人体模型试验。使用NIO、BIG、EZ-IO和Jamshidi时骨内穿刺的正确位置各不相同，分别为100%、90%、90%和90%。NIO、BIG、EZ-IO和Jamshidi获得血管内穿刺所需的时间（时间T1）各不相同，NIO为9秒[四分位距，8 - 12]，BIG为12秒[四分位距，9 - 16]，EZ-IO为13.5秒[四分位距，11 - 17]，Jamshidi为15秒[四分位距，13 - 19]。护理人员根据操作的主观难易程度对每种装置进行评估。事实证明，最易于使用的骨内装置是NIO，在心肺复苏情况下，其获得的中位数评分为1.5（四分位距，0.5 - 1.5）分。
我们的研究发现NIO®优于BIG®、EZ-IO®和Jamshidi。NIO®首次尝试成功率最高。NIO®插入所需时间也最少，即使是新手用户也最易于操作。需要进一步研究以在尸体或人体受试者中验证我们的发现。基于我们的研究结果，NIO®是一种有前景的用于儿科复苏的骨内装置。已知信息：• 急性病儿科患者，如正在进行心肺复苏的患者，需要静脉通路以便迅速给药和补液。• 如果难以迅速获得血管通路以防止治疗延误，美国心脏协会和欧洲复苏委员会推荐采用骨内穿刺。新发现：• 本模拟儿科复苏在人体模型中比较了四种市售儿科骨内装置的性能。• 在新手用户中，NIO®在首次尝试成功率和操作时间方面优于BIG®和EZ-IO®及Jamshidi。
