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Vol 2, No 3 (2017)
ORIGINAL ARTICLE
Published online: 2017-10-20
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Knowlege and attitudes toward intraosseous access among emergency medical service practitioners in Poland

Lukasz Szarpak1, Jacek Smereka2, Rafal Czyz2, Jerzy Robert Ladny3, Marek Dabrowski4, Quinton Riter5, Kurt Ruetzler5
·
Disaster Emerg Med J 2017;2(3):112-115.
Affiliations
  1. Medical University Warsaw
  2. Wroclaw Medical University
  3. Department of Emergency Medicine and Disaster, Medical University of Bialystok, Szpitalna 37, 15-295 Bialystok, Poland
  4. Poznan University of Medical Sciences
  5. Cleveland Clinic, 9500 Euclid Avenue, 44195 Cleveland, United States

open access

Vol 2, No 3 (2017)
ORIGINAL ARTICLE
Published online: 2017-10-20

Abstract

INTRODUCTION: The administration of fluids, drugs and blood products is frequently indicated in patients suffering from serious injury or illness in the out-of-hospital emergency setting. Placement of a peripheral venous catheter may be challenging and several insertion attempts may delay intravenous therapy. Intraosseous access serves as a valuable alternative. However, this technique is rarely performed and knowledge of its use may not remain satisfactory in out-of-hospital Emergency Medical Service (EMS) personnel.

METHODS: A written invitation to participate in this questionnaire study was sent to all EMS providers in Poland. Participants were asked to answer an online questionnaire consisting of 10 questions about their knowledge, ex­perience, and training of intraosseous devices. All answers were collected and processed anonymously.

RESULTS: 438 out of 550 Polish EMS providers with a median experience of 5 years completed the questionnaire. Although 88% confirmed that there is an intraosseous access device available in their ambulance, only 47% had previously performed the procedure. Moreover, 48% reported subjective psychological barriers to obtaining an intraosseous access and 37% reported that intraosseous access should not be performed on paediatric patients.

DISCUSSION: Intraosseous devices are widely available in many ambulances. Experience and knowledge regarding intraosseous access remains unsatisfactory among Polish EMS providers. Critical review of training and education curricula is therefore indicated.

Abstract

INTRODUCTION: The administration of fluids, drugs and blood products is frequently indicated in patients suffering from serious injury or illness in the out-of-hospital emergency setting. Placement of a peripheral venous catheter may be challenging and several insertion attempts may delay intravenous therapy. Intraosseous access serves as a valuable alternative. However, this technique is rarely performed and knowledge of its use may not remain satisfactory in out-of-hospital Emergency Medical Service (EMS) personnel.

METHODS: A written invitation to participate in this questionnaire study was sent to all EMS providers in Poland. Participants were asked to answer an online questionnaire consisting of 10 questions about their knowledge, ex­perience, and training of intraosseous devices. All answers were collected and processed anonymously.

RESULTS: 438 out of 550 Polish EMS providers with a median experience of 5 years completed the questionnaire. Although 88% confirmed that there is an intraosseous access device available in their ambulance, only 47% had previously performed the procedure. Moreover, 48% reported subjective psychological barriers to obtaining an intraosseous access and 37% reported that intraosseous access should not be performed on paediatric patients.

DISCUSSION: Intraosseous devices are widely available in many ambulances. Experience and knowledge regarding intraosseous access remains unsatisfactory among Polish EMS providers. Critical review of training and education curricula is therefore indicated.

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Keywords

intraosseous access, emergency medicine, Emergency Medical Service

About this article
Title

Knowlege and attitudes toward intraosseous access among emergency medical service practitioners in Poland

Journal

Disaster and Emergency Medicine Journal

Issue

Vol 2, No 3 (2017)

Pages

112-115

Published online

2017-10-20

Page views

778

Article views/downloads

901

DOI

10.5603/DEMJ.2017.0024

Bibliographic record

Disaster Emerg Med J 2017;2(3):112-115.

Keywords

intraosseous access
emergency medicine
Emergency Medical Service

Authors

Lukasz Szarpak
Jacek Smereka
Rafal Czyz
Jerzy Robert Ladny
Marek Dabrowski
Quinton Riter
Kurt Ruetzler

References (9)
  1. Lee PMJ, Lee C, Rattner P, et al. Intraosseous versus central venous catheter utilization and performance during inpatient medical emergencies. Crit Care Med. 2015; 43(6): 1233–1238.
  2. Petitpas F, Guenezan J, Vendeuvre T, et al. Use of intra-osseous access in adults: a systematic review. Crit Care. 2016; 20: 102.
  3. Neuhaus D. Intraosseous infusion in elective and emergency pediatric anesthesia: when should we use it? Curr Opin Anaesthesiol. 2014; 27(3): 282–287.
  4. Burgert JM. A primer on intraosseous access: History, clinical considerations, and current devices. Am J Disaster Med. 2016; 11(3): 167–173.
  5. Reades R, Studnek JR, Vandeventer S, et al. Intraosseous versus intravenous vascular access during out-of-hospital cardiac arrest: a randomized controlled trial. Ann Emerg Med. 2011; 58(6): 509–516.
  6. Szarpak L, Truszewski Z, Smereka J, et al. A Randomized Cadaver Study Comparing First-Attempt Success Between Tibial and Humeral Intraosseous Insertions Using NIO Device by Paramedics: A Preliminary Investigation. Medicine (Baltimore). 2016; 95(20): e3724.
  7. Hallas P, Folkestad L, Brabrand M. How many training modalities are needed to obtain procedural confidence in intraosseous access? A questionnaire study. Eur J Emerg Med. 2011; 18(6): 360–362.
  8. Santos D, Carron PN, Yersin B, et al. EZ-IO(®) intraosseous device implementation in a pre-hospital emergency service: A prospective study and review of the literature. Resuscitation. 2013; 84(4): 440–445.
  9. Von Hoff DD, Kuhn JG, Burris HA, et al. Does intraosseous equal intravenous? A pharmacokinetic study. Am J Emerg Med. 2008; 26(1): 31–38.

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