Background Quick and successful vascular access in injured patients arriving in extremis is crucial to enable early resuscitation and rapid OR transport for definitive repair. We hypothesized that intraosseous (IO) access would be faster and have higher success rates than peripheral IVs (PIVs) or central venous catheters (CVCs). Methods High-definition video recordings of resuscitations for all patients undergoing Emergency Department Thoracotomy (EDT) from 4/2016-7/2017 were reviewed as part of a quality improvement initiative. Demographics, mechanism of injury, access type, access location, start and stop time, and success of each vascular access attempt were recorded. Times to completion for access types (PIV, IO, CVC) were compared using Kruskal-Wallis test adjusted for multiple comparisons while categorical outcomes such as success rates by access type were compared using chi-squared test or Fisher’s exact test. Results Study patients had a median age of 30 (IQR 25-38), were 92% male, 92% African American, and 93% sustained penetrating trauma. A total of 145 access attempts in 38 patients occurred (median 3.8 (SD 1.4) attempts per patient). There was no difference between duration of PIV and IO attempts (0.63 IQR 0.35-0.96 vs. 0.39 IQR 0.13-0.65 minutes, adjusted p = 0.03), but both PIV and IO were faster than CVC attempts (3.2 IQR 1.72 – 5.23 minutes, adjusted p
from Emergency Medicine via xlomafota13 on Inoreader http://ift.tt/2lTePoV
Εγγραφή σε:
Σχόλια ανάρτησης (Atom)
Δημοφιλείς αναρτήσεις
-
Reuters Health News from Emergency Medicine via xlomafota13 on Inoreader http://ift.tt/2rI2pFX
-
The new system cuts out the practice of “over triaging calls” and uses an algorithm to suggest to dispatchers what resources are needed fr...
-
Noninvasive ventilation (NIV) is the first-line treatment of adult patients with exacerbations of cystic fibrosis (CF). High-flow nasal oxyg...
-
The new system is meant to allow people who are hard of hearing, speech-impaired or unable to talk safely on the phone to connect with emerg...
-
Objective: It was hypothesized that adding dedicated afternoon rounds for patients’ families to supplement standard family support would imp...
-
International Journal of Environmental Research... Latest Results for Sleep and BreathingIntermitt... Evolutionary Biology News -- S...
-
The American Journal of Emergency Medicine from Emergency Medicine via xlomafota13 on Inoreader http://ift.tt/2iKBYYz
-
Big dreams to improve EMS with a windfall of funding for safety, health and wellness, research and leadership development from EMS via xlo...
-
No abstract available from Emergency Medicine via xlomafota13 on Inoreader http://ift.tt/1ZlzU7L
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου