Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Paediatric Emergency Department, Rambam Health Care Campus, Haifa, Israel.
Arch Dis Child Fetal Neonatal Ed. 2022 May;107(3):289-292. doi: 10.1136/archdischild-2021-321988. Epub 2021 Aug 2.
To compare the success rates and ease of use of three intraosseous (IO) access devices used in term neonates.
A three-arm randomised controlled simulation study was conducted.
A simulation laboratory.
Seventy-two paediatric residents completing their emergency department rotation as part of their residency training, and 20 paediatric specialists.
Using an animal bone model, the one-attempt success rate of the EZ-IO drill, the NIO-I needle and the Jamshidi needle was compared. Uncooked Cornish Hen bones were used because of their similarity in length and diameter to the bones of neonates. Participants were asked to record the perceived ease of use of their assigned device using a 5-point Likert Scale.
The main outcome was the visualisation of flow emerging from the distal end of the bone, and perceived ease of use of the three IO devices.
The EZ-IO, NIO-I and Jamshidi groups included 30, 31 and 31 participants, respectively, with median (IQR) years of experience of 3 (2-5), 3 (2-6) and 4 (3-5) years. Participants had significantly lower one-attempt success rates with the EZ-IO drill than with the NIO-I and the Jamshidi needles (14 of 30 (46.7%) vs 24 of 31 (77.4%); p=0.016, and 14 of 30 (46.7%) vs 25 of 31 (80.7%); p=0.007, respectively). The median (IQR) ease-of-use score of the EZ-IO drill was higher than that of the NIO-I and Jamshidi needles (5 (4-5) vs 4 (4-5); p=0.008, and 5 (4-5) vs 4 (3-4); p=0.0004, respectively).
Although easier to use, the EZ-IO drill demonstrated lower success rates than the IO needles in establishing IO access on a neonatal bone model.
比较三种用于足月新生儿的骨内（IO）接入设备的成功率和易用性。
三臂随机对照模拟研究。
模拟实验室。
72 名完成急诊轮转的儿科住院医师，以及 20 名儿科专家。
使用动物骨模型比较 EZ-IO 钻头、NIO-I 针和 Jamshidi 针的一次性成功率。选择未烘焙的康沃尔火鸡骨，因为它们在长度和直径上与新生儿的骨骼相似。参与者被要求使用 5 分制 Likert 量表记录他们所分配设备的易用性感知。
主要结果是观察从骨远端流出的血流，并感知三种 IO 设备的易用性。
EZ-IO、NIO-I 和 Jamshidi 组分别包括 30、31 和 31 名参与者，中位（IQR）经验年限分别为 3（2-5）、3（2-6）和 4（3-5）年。与 NIO-I 和 Jamshidi 针相比，EZ-IO 钻头的一次性成功率明显较低，分别为 30 名参与者中的 14 名（46.7%）比 31 名中的 24 名（77.4%）（p=0.016）和 30 名中的 14 名（46.7%）比 31 名中的 25 名（80.7%）（p=0.007）。EZ-IO 钻头的中位（IQR）易用性评分高于 NIO-I 和 Jamshidi 针，分别为 5（4-5）比 4（4-5）（p=0.008）和 5（4-5）比 4（3-4）（p=0.0004）。
尽管 EZ-IO 钻头更易于使用，但在建立新生儿骨模型的 IO 接入方面，其成功率低于 IO 针。
