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Observational review of paediatric intraosseous needle placement in the paediatric emergency department
Author(s) -
Pifko Elysha L,
Price Amanda,
Busch Carrie,
Smith Curren,
Jiang Yunyun,
Dobson Joseph,
Tuuri Rachel
Publication year - 2018
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.13773
Subject(s) - medicine , emergency department , observational study , tertiary care , significant difference , paediatric intensive care unit , retrospective cohort study , cardiopulmonary resuscitation , emergency medicine , resuscitation , pediatrics , surgery , psychiatry
Aim Intraosseous ( IO ) access is a life‐saving option during resuscitations in the paediatric emergency department ( PED ). This study aimed to compare success rates and time to placement for Manual IO versus EZ‐IO needles in PED patients ≤8 and >8 kg. Methods This was a retrospective cross‐sectional descriptive study of IO use in a single‐centre tertiary PED from 2006 to 2014. Cases were identified through diagnosis codes for IO infusion, cardiopulmonary resuscitation and cardiac arrest and admissions to the intensive care unit. Categorical measures were compared with Z ‐test for comparison of two proportions and continuous with Student's t ‐tests. Results Of 1748 charts screened, 50 had an IO attempted. In patients ≤8 kg, Manual IO had success rate of 55% (17/31) versus 47% (8/17) for EZ‐IO ( P = 0.61). In patients >8 kg, Manual had success rate of 100% (2/2) versus 93% (14/15) for EZ‐IO ( P = 0.71). Manual performance was no different for ≤8 kg than >8 kg ( P = 0.21), but EZ‐IO was less successful for ≤8 kg than >8 kg ( P = 0.005). In patients ≤8 kg, Manual IO had a shorter time to placement at 4.5 min versus 12.8 for EZ‐IO ( P = 0.02). Conclusion We observed no difference in performance between Manual and EZ‐IO devices in children ≤8 kg, but the Manual IO were placed more quickly. We observed lower success rates with EZ‐IO devices in children ≤8 kg compared to >8 kg. Future investigations should focus specifically on training for IO placement in children ≤8 kg.