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Intraosseous versus intravenous access while wearing personal protective equipment: a meta-analysis in the era of

Anna Drozd1, Jacek Smereka1,2, Krzysztof J Filipiak3

  • 1Polish Society of Disaster Medicine, Warsaw, Poland

Kardiologia Polska
|January 8, 2021
PubMed

Insights

When wearing personal protective equipment (PPE), intraosseous access is faster and more successful than peripheral intravenous access for emergency vascular procedures. This finding is crucial for optimizing patient care in high-risk settings.

Area of Science:

  • Emergency Medicine
  • Critical Care
  • Medical Procedures

Background:

  • Vascular access is a critical procedure in emergency care.
  • The COVID-19 pandemic necessitated the use of full personal protective equipment (PPE) during medical interventions.
  • The impact of PPE on vascular access methods in emergency settings required investigation.

Purpose of the Study:

  • To compare the efficacy of different intravascular access methods in patients requiring vascular access while wearing full PPE.
  • To determine the optimal intravascular access strategy for healthcare providers under stringent personal protective equipment (PPE) conditions.

Main Methods:

  • A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted.
  • Searched PubMed, EMBASE, and CENTRAL databases for relevant RCTs.
  • Evaluated procedure duration and success rates for intraosseous and peripheral intravenous access under full PPE.

Main Results:

  • Eight RCTs were included in the quantitative synthesis.
  • Personal protective equipment (PPE) significantly increased procedure duration for intraosseous access (MD, 11.69s).
  • Personal protective equipment (PPE) reduced success rates for both intraosseous (0.8%) and intravenous (10.1%) access.
  • Intraosseous access was faster (MD, -41.43s) and more successful than peripheral intravenous access under PPE.

Conclusions:

  • Personal protective equipment (PPE) significantly prolongs intravascular procedure times.
  • Despite PPE, intraosseous access offers a shorter procedure time and higher success rate compared to peripheral intravenous access.
  • Intraosseous access is recommended for emergency vascular procedures when full PPE is required.
Abstract

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