Structured training in intraosseous infusion to improve potentially life saving skills in pediatric emergencies - Results of an open prospective national quality development project over 3 years

Pfister, Christoph Alexander; Egger, Lars; Wirthmüller, Beat; Greif, Robert (2008). Structured training in intraosseous infusion to improve potentially life saving skills in pediatric emergencies - Results of an open prospective national quality development project over 3 years. Pediatric anesthesia, 18(3), pp. 223-9. Oxford: Wiley-Blackwell 10.1111/j.1460-9592.2007.02348.x

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BACKGROUND: Children in emergencies need peripheral intravenous (IV) access in order to receive drugs or fluids. The success of IV access is associated with the age of patients and fails in up to 50% of children younger than 6 years. In such situations, it is essential that physicians and paramedics have a tool and easily learnable skills with a high chance of success. According to international guidelines intraosseous (IO) access would be the next step after failed IV access. Our hypothesis was that the success rate in IO puncturing can be improved by standardizing the training; so we developed an IO workshop. METHODS: Twenty-eight hospitals and ambulance services participated in an evaluation process over 3 years. IO workshops and the distribution of standardized IO sets were coordinated by the study group of the University Hospital of Berne. Any attempted or successful IO punctures were evaluated with a standardized interview. RESULTS: We investigated 35 applications in 30 patients (a total of 49 punctures) between November 2001 and December 2004. IO puncture was not successful in 5 patients. The success rate depended neither on the occupation nor the experience of users. Attendance at a standardized IO workshop increased the overall success rate from 77% to 100%, which was statistically not significant (P = 0.074). CONCLUSIONS: Standardized training in IO puncturing seems to improve success more than previous experience and occupation of providers. However, we could not show a significant increase in success rate after this training. Larger supranational studies are needed to show a significant impact of teaching on rarely used emergency skills.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy

UniBE Contributor:

Egger, Lars; Wirthmüller, Beat and Greif, Robert

ISSN:

1155-5645

ISBN:

18230065

Publisher:

Wiley-Blackwell

Language:

English

Submitter:

Jeannie Wurz

Date Deposited:

04 Oct 2013 15:01

Last Modified:

23 Jan 2018 12:17

Publisher DOI:

10.1111/j.1460-9592.2007.02348.x

PubMed ID:

18230065

Web of Science ID:

000253313200005

URI:

https://boris.unibe.ch/id/eprint/26672 (FactScience: 81110)

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