Brunette D D, Fischer R
Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN 55415.
Am J Emerg Med. 1988 Nov;6(6):577-9. doi: 10.1016/0735-6757(88)90094-0.
All cases of patients aged less than 48 months who presented in cardiac arrest to the Hennepin County Medical Center's emergency department (ED) during the years 1984 to 1986 were reviewed retrospectively. The ED record, initial and subsequent chest radiographs, hospital charts, and autopsy reports were analyzed. A total of 33 cases were reviewed. The average patient age was 5 months. The average time needed to establish intravascular access was 7.9 +/- 4.2 minutes. Success rates were 77% for central venous catheterization, 81% for surgical vein cutdown, 83% for intraosseous infusion, and 17% for percutaneous peripheral catheterization. Percutaneous peripheral catheterization, when successful, and bone marrow needle placement were the fastest methods of obtaining intravascular access. There were no major immediate complications, and delayed complications were minimal. Attempts at peripheral intravenous catheter placement should be brief, with rapid progression to intraosseous infusion if peripheral attempts are not successful.
对1984年至1986年间在亨内平县医疗中心急诊科（ED）出现心脏骤停的所有年龄小于48个月的患儿病例进行了回顾性研究。分析了ED记录、初始及后续胸部X光片、医院病历和尸检报告。共回顾了33例病例。患者平均年龄为5个月。建立血管内通路所需的平均时间为7.9±4.2分钟。中心静脉置管成功率为77%，手术静脉切开置管成功率为81%，骨髓腔内输液成功率为83%，经皮外周静脉置管成功率为17%。经皮外周静脉置管成功时以及骨髓穿刺针穿刺是获得血管内通路最快的方法。无重大即刻并发症，延迟并发症极少。外周静脉置管尝试应简短，如果外周尝试不成功应迅速改为骨髓腔内输液。
