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Pediatric Intraosseous Access Performed by Emergency Department Nurses Using Semiautomatic Devices: A Randomized
Oren Feldman1, Najib Nasrallah1, Yuval Bitterman2
1From the Emergency Department.
Pediatric Emergency Care
|September 27, 2018
Summary
Emergency department nurses and paramedics demonstrate comparable success rates in pediatric intraosseous (IO) access using semiautomatic devices. This pilot study indicates ED nurses are proficient in performing IO procedures.
Area of Science:
- Emergency Medicine
- Pediatric Critical Care
- Medical Simulation
Background:
- Intraosseous (IO) access is a critical intervention for pediatric emergencies.
- No prior studies have evaluated the performance of emergency department (ED) nurses in establishing IO access.
- This study addresses the knowledge gap regarding ED nurses' proficiency with IO devices.
Purpose of the Study:
- To evaluate the success rate of ED nurses in establishing pediatric IO access.
- To compare the performance of ED nurses with paramedics using semiautomatic IO devices.
- To assess the ease of use of different IO devices by healthcare professionals.
Main Methods:
- A randomized crossover simulation study was conducted using a pediatric bone model (uncooked piglets' bones).
- ED nurses and experienced paramedics performed IO access attempts using the spring-loaded injector (NIO) and battery power drill (EZ-IO).
- Success was defined by visualizing marrow cavity flow; ease of use was self-ranked by participants.
Main Results:
- No significant difference in the 1-attempt success rate was observed between nurses and paramedics (79.4% vs 83.3%).
- Both groups achieved similar success rates with both the NIO and EZ-IO devices.
- Failure rates and causes were equally distributed; nurses found the EZ-IO easier to use than the NIO.
Conclusions:
- ED nurses and paramedics exhibit comparable high success rates in pediatric IO access insertion on a simulation model.
- This pilot study suggests ED nurses are capable of successfully performing intraosseous access procedures.
- Findings support the integration of ED nurses in performing IO access in pediatric emergencies.
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