UMEM Educational Pearls

  • Intraosseous (IO) is well-recognized as a venous line for delivering a variety of medications, including vasopressors. However, there is not a wealth of literature to support the use of IOs when administering medications for rapid sequence intubation (RSI).
  • This prospective observational study was conducted to determine whether an IO can be used to reliably and rapidly administers medications during RSI in trauma patients.
  • Thirty-four trauma patients were enrolled in the study and patients had a variety of traumatic mechanisms; blunt, penetrating, burns, and blast. The primate study outcome was the success rate of first-pass intubations using direct laryngoscopy.
  • The authors demonstrated a first pass success rate of 97% with a grade I view on 91% of attempts.
  • Bottom-line: This is yet another study demonstrating that when rapid and reliable access is needed, IO is an excellent option for venous access.

References

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Barnard, et al. Rapid sequence induction of anaesthesia via the intraosseous route: a prospective observational study. Emerg Med J. 2014 Jun 24. pii: emermed-2014-203740.