Current Status of Intraosseous Infusion Technique Use at Emergency Departments in Korea

국내 응급실에서의 골수강내 주입법 사용 현황

  • Choi, Sang Cheon (Department of Emergency Medicine, Gyeongsang Hospital) ;
  • Park, Hyun Soo (Department of Emergency Medicine, Ajou University School of Medicine) ;
  • Kim, Jae Woo (Department of Emergency Medicine, Soonchunhyang University Cheonan Hospital)
  • 최상천 (경상병원 응급의학과) ;
  • 박현수 (아주대학교 의과대학 응급의학교실) ;
  • 김재우 (순천향대학교 천안병원 응급의학과)
  • Received : 2006.11.27
  • Accepted : 2007.05.09
  • Published : 2007.06.30

Abstract

Purpose: Gaining vascular access is difficult and time-consuming in critically ill children, so nowdays, in many countries, intraosseous vascular access is frequently used for rapid vascular access in critically ill children. Its pharmacokinetics is close to that of the peripheral intravenous route, but its infusion flow rate is faster. The purpose of this study was to determine how widely the intraosseous infusion technique was being used in Korean emergency departments. Methods: We telephoned forty-two (42) randomly selected university-affiliated hospitals. We asked physicians if they use the intraosseous infusion technique. Responders were emergency and pediatric residents and emergency faculty. If they responded that they were not using the intraosseous infusion technique, we asked the reason. Also, we asked about their experiences with the intraosseous infusion technique. Results: Forty-two (42) hospitals were enrolled in this study. No hospital used the intraosseous infusion technique on a regular basis. However, 8 hospitals used the intraosseous infusion technique occasionally. None of the responders had experience with the intraosseous infusion technique. Conclusion: The intraosseous infusion technique is currently underrepresented at emergency departments in Korea.

Keywords

References

  1. Stovroff M, Teague WG. Intravenous access in infants and children. Pediatr Clin North Am 1998;45:1373-93 https://doi.org/10.1016/S0031-3955(05)70095-X
  2. Oriot D, Cardona J, Berthier M, Nasimi A, Boussemart T. Intraosseous vascular access, a technic previously underestimated in France. Arch Pediatr 1994;1:684-8
  3. Rosovsky M, FitzPatrick M, Goldfarb CR, Finestone H. Bilateral osteomyelitis due to intraosseous infusion: Case report and Review of the English language literature. Pediatr Radiol 1994;24:72-3 https://doi.org/10.1007/BF02017671
  4. Rosetti VA, Thompson BM, Abrahamian C, Miller J, Mateer JR. Difficulty and delay in intravascular access in pediatric arrest (abstract). Ann Emerg Med 1984;13:406
  5. Orlowski JP. Emergency alternatives to intravenous access; Intraosseous, intrathecal, sublingual, and other site drug administration. Pediatr Clin North Am 1994;41:1183-99 https://doi.org/10.1016/S0031-3955(16)38868-X
  6. Rosetti VA, Thompson BM, Miller J, Mateer JR, Aprahamian C. Intraosseous infusion; an alternative route of pediatric intravascular access. Am J Emerg Med 1985;14:885-8 https://doi.org/10.1016/S0196-0644(85)80639-9
  7. The American Heart Association in Collaboration with the International Liaison Committee on Resuscitation (ILCOR): Guidelines 2000 for Cardiopulmonary resuscitation and Emergency Cardiovascular Care. Circulation (Supplement) 2000;102:I-305
  8. Galeser P, Losek J, Nelson D, Bonadio WA, Smith DS, Walsh-Kelly C, et al. Pediatric intraosseous infusion: impact on vascular access time. Am J Emerg Med 1988; 6:330-2 https://doi.org/10.1016/0735-6757(88)90149-0
  9. Calkins MD, Fitzgerald G, Bentley TB, Burris D. Intraosseous infusion devices: a comparison for potential use in special operations. J Trauma 2000;48:1068-74 https://doi.org/10.1097/00005373-200006000-00012
  10. Chan TC. Cardiovascular system. In Rosen P, Chan TC, Vilke GM, Sternbach G, eds. Atlas of Emergency Procedures. 1st ed. St. Louis: Mosby Inc; 2001:98-9
  11. Johnson L, Kissoon N, Fiallos M, Abdelmoneim T, Murphy S. Use of intraosseous blood to assess blood chemistries and hemoglobin during cardiopulmonary resuscitaion with drug infusions. Crit Care Med 1999; 27:1147-52 https://doi.org/10.1097/00003246-199906000-00039
  12. Abdelmoneim T, Kissoon N, Johnson L, Fiallos M, Murphy S. Acid-base status of blood from Intraosseous and mixed venous sites during prolonged cardiopulmonary resuscitation and drug infusion. Crit Care Med 1999;27:1923-8 https://doi.org/10.1097/00003246-199909000-00034
  13. Gayle M, Kissoon N. A case of compartment syndrome following intraosseous infusions. Pediatr Emerg Care 1994;10:378
  14. Bowley DM, Loveland J, Pitcher GJ. Tibial fracture as a complication of intraosseous infusion during pediatric resuscitation. J Trauma 2003;55:786-7.
  15. Hodge D. Intraosseous infusion. In Henretig FM, King CC, eds. Textbook of Pediatric Emergency procedure. 3rd ed. Baltimore, Md: Williams & Wilkins; 1997: 289-98