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Intraosseous emergency access by physicians wearing full protective gear
Ron Ben-Abraham1, Ilan Gur, Youri Vater
1Department of Anesthesiology and Critical Care Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Summary
Establishing intraosseous access with the Bone Injection Gun (BIG) is feasible even with protective gear. While slightly slower (32 seconds vs. 22 seconds), the success rate remains high, offering potential benefits for toxic mass casualty incidents.
Area of Science:
- Emergency Medicine
- Trauma Care
- Toxicology
Background:
- Intraosseous access is a critical route for fluid and medication delivery in emergencies.
- The use of personal protective equipment (PPE) can impact the speed and efficacy of medical procedures.
Purpose of the Study:
- To evaluate the feasibility, speed, and success rate of intraosseous access using the Bone Injection Gun (BIG).
- To assess the impact of antichemical protective gear on the performance of intraosseous needle insertion.
Main Methods:
- Prospective, randomized study using a turkey bone model.
- Comparison of intraosseous needle placement time with and without full antichemical protective gear (body suit, mask, gloves).
- Measurement of time to proper placement and success rate.
Main Results:
- Successful intraosseous insertion with the BIG took an average of 32 ± 3 seconds while wearing protective gear, compared to 22 ± 2 seconds without it (p<0.05).
- The success rate for initial needle placement was ≥80%.
- Any initial failures were overcome with a second attempt.
Conclusions:
- Intraosseous insertion using the BIG is a rapid and effective technique.
- Wearing protective gear increases insertion time by approximately 50% but does not significantly compromise success.
- The BIG is a potentially beneficial tool for emergent treatment in toxic mass casualty situations, warranting further investigation.