Kanter R K, Zimmerman J J, Strauss R H, Stoeckel K A
Am J Dis Child. 1986 Feb;140(2):132-4. doi: 10.1001/archpedi.1986.02140160050030.
Effectiveness of a protocol for intravenous (IV) access during pediatric resuscitation was prospectively evaluated to determine whether utilization of a specified sequence of measures would reduce IV access time compared with resuscitations deviating from the protocol. The protocol involved rapid sequential attempts at percutaneous femoral vein catheterization, saphenous vein cutdown, and intraosseous infusions if initial percutaneous peripheral IV insertion failed. While no single technique provided completely reliable and rapid IV access, utilization of all techniques per protocol significantly improved IV access time. When initial percutaneous peripheral IV attempts failed, resuscitations in compliance with the protocol achieved IV access more rapidly (median, 4.5 minutes) than those deviating from the protocol (median, 10.0 minutes). Even with incomplete compliance, 66% of resuscitations achieved IV access within the first five minutes. Our experience indicates that IV access during pediatric resuscitation should rarely be delayed beyond the fifth minute if all available IV techniques are used.
对小儿复苏期间静脉（IV）通路建立方案的有效性进行了前瞻性评估，以确定与偏离该方案的复苏相比，采用特定措施顺序是否会减少静脉通路建立时间。该方案包括在初始经皮外周静脉穿刺失败时，迅速依次尝试经皮股静脉置管、大隐静脉切开术和骨内输液。虽然没有单一技术能提供完全可靠且快速的静脉通路，但按照方案使用所有技术显著改善了静脉通路建立时间。当初始经皮外周静脉穿刺尝试失败时，符合该方案的复苏比偏离该方案的复苏能更快地建立静脉通路（中位数，4.5分钟对10.0分钟）。即使依从性不完全，66%的复苏在头五分钟内成功建立了静脉通路。我们的经验表明，如果使用所有可用的静脉技术，小儿复苏期间的静脉通路建立很少应延迟超过五分钟。
