Current status of establishing a venous line in CPA patients by Emergency Life-Saving Technicians in the prehospital setting in Japan and a proposal for intraosseous infusion.

Isayama, K ; Nakatani, T ; et al.

In: International journal of emergency medicine, Jg. 5 (2012-01-09), Heft 1, S. 2

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Introduction: It is important to have a venous line in cardiopulmonary arrest (CPA) patients as an emergency treatment measure in prehospital settings, but establishment of a peripheral venous line is difficult in such patients. This study aimed to investigate the current status of intravenous infusion (IVI) in CPA patients by Emergency Life-Saving Technicians (ELSTs) in Japan. We also considered alternative measures in case IVI was difficult or impossible.

Methods: We investigated a nationwide database between 1 January 2005 and 31 December 2008. From a total of 431,968 CPA cases, we calculated the IVI success rate and related parameters.The Bone Injection Gun (BIG) and simulator legs (adult, pediatric, and infant) were used by 100 ELSTs selected for the study to measure the time required and the success rate for intraosseous infusion (IOI).

Results: The number of CPA patients, IVI, adrenaline administration, and the IVI success rate in adult CPA patients increased every year. However, the IVI success rate in pediatric CPA patients did not increase. Although adrenaline administration elevated the ROSC rate, there was no improvement in the 1-month survival rate. The time required for IOI with BIG was not different among the leg models. The success rates of IOI with BIG were 93%, 94%, and 84% (p < 0.05 vs. adult and pediatric) in adult, pediatric, and infant models, respectively.

Conclusions: The rate of success of IVI in adult CPA patients has been increased yearly in Japan. However, as establishing a peripheral venous line in pediatric patients (1-7 years old) by ELSTs is extremely difficult in prehospital settings, there was no increase in the IVI success rate in such patients. As the study findings indicated IOI with BIG was easy and rapid, it may be necessary to consider IOI with BIG as an alternative option in case IVI is difficult or impossible in adult and pediatric patients.

Titel:	Current status of establishing a venous line in CPA patients by Emergency Life-Saving Technicians in the prehospital setting in Japan and a proposal for intraosseous infusion.
Autor/in / Beteiligte Person:	Isayama, K ; Nakatani, T ; Tsuda, M ; Hirakawa, A
Link:	Volltext (PDF) View record at Springer (Volltext)
Zeitschrift:	International journal of emergency medicine, Jg. 5 (2012-01-09), Heft 1, S. 2
Veröffentlichung:	[2018]- : [London, United Kingdom] : BioMed Central ; <i>Original Publication</i>: London : Springer, c2008-c2017., 2012
Medientyp:	academicJournal
ISSN:	1865-1380 (electronic)
DOI:	10.1186/1865-1380-5-2
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article Language: English [Int J Emerg Med] 2012 Jan 09; Vol. 5 (1), pp. 2. <i>Date of Electronic Publication: </i>2012 Jan 09. References: Int J Emerg Med. 2009 Aug 11;2(3):155-60. (PMID: 20157465) ; Prehosp Disaster Med. 2006 Sep-Oct;21(5):329-34. (PMID: 17297903) ; Resuscitation. 2010 Sep;81(9):1152-5. (PMID: 20732607) ; J Trauma. 2009 Jun;66(6):1739-41. (PMID: 19509638) ; Resuscitation. 2008 Sep;78(3):314-9. (PMID: 18573590) ; J Trauma. 2008 Mar;64(3):650-4; discussion 654-5. (PMID: 18332804) ; J R Soc Med. 1995 Apr;88(4):213P-216P. (PMID: 7745568) ; Resuscitation. 2000 Oct;47(2):137-46. (PMID: 11008151) ; J Trauma. 2009 Sep;67(3):606-11. (PMID: 19741408) ; Resuscitation. 2005 Jan;64(1):21-9. (PMID: 15629551) ; Resuscitation. 2010 Oct;81(10):1364-88. (PMID: 20956047) ; J Emerg Med. 2005 Feb;28(2):237-41. (PMID: 15707828) ; Resuscitation. 2010 Aug;81(8):994-9. (PMID: 20434823) ; Health Technol Assess. 2000;4(31):1-57. (PMID: 11109030) ; J Trauma. 2000 Jun;48(6):1068-74. (PMID: 10866253) ; Int J Emerg Med. 2009 Apr;2(1):7-12. (PMID: 19390911) ; J Trauma. 2009 Aug;67(2):389-402. (PMID: 19667896) ; Am J Dis Child. 1990 Jan;144(1):112-7. (PMID: 1688484) ; Resuscitation. 2009 Sep;80(9):1029-33. (PMID: 19586701) ; Crit Care Med. 1999 Aug;27(8):1565-9. (PMID: 10470765) ; Resuscitation. 2004 Oct;63(1):7-9. (PMID: 15451580) ; Resuscitation. 2002 Dec;55(3):241-6. (PMID: 12458060) ; Ann Emerg Med. 1991 Aug;20(8):861-74. (PMID: 1854070) ; JAMA. 2009 Nov 25;302(20):2222-9. (PMID: 19934423) ; Vet Surg. 2002 Nov-Dec;31(6):533-40. (PMID: 12415522) ; Am J Dis Child. 1986 Feb;140(2):132-4. (PMID: 3946322) ; Resuscitation. 2004 Mar;60(3):239-44. (PMID: 15050754) ; N Engl J Med. 2010 Mar 18;362(11):994-1004. (PMID: 20237345) Entry Date(s): Date Created: 20120111 Date Completed: 20121002 Latest Revision: 20211021 Update Code: 20231215 PubMed Central ID: PMC3268708

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