Randomizowane badanie manekinowe porównujące skuteczność uzyskania dostępu doszpikowego i dożylnego u dziecka podczas symulowanego wstrząsu hipowolemicznego – doniesienie wstępne

Abstract

IntroductionEnsuring intravascular access during the state of immediate threat to life is a key element of the provision of medical treatment. PurposeThe aim of the study was to compare the time for obtaining the infusion and the effective intraosseous and intravenous access performed by emergency medical students in relation to a pediatric patient during simulated hypovolemic shock scenario. Material and methodsThe study was a randomized crossover study. Fifty-three emergency medical students performed intravenous access using standard intravenous cannula (SKD) and intraosseous access using a Bone Injection Gun (B.I.G.) at random section. We measured efficacy of intravascular access, time needed for intravascular access (time T1), time to stabilize the intravascular injection (time T2) and time of infusion line connection (time T3). In addition, we investigated the ease of the procedure and the preferences of participants. ResultsThe efficacy of the first intravascular access attempts with the use of SKD and B.I.G. was respectively 81.1% and 96.2% (p=0.023). The overall efficacy of both methods was 100%. The median duration of access (time T1) was 39 s (IQR, 32–46) for SAD and 15 s (IQR, 12–21) for B.I.G. (p<0.001). The results for B.I.G. were statistically significantly better than in the case of SKD (p<0.001) for the time T2, time T3, ease of execution procedures and preferences of participants. ConclusionsIn this trial with the use of manikin which simulates a 6-year-old child, paramedic students who do not have prior experience with intraosseous access devices were able with higher efficiency and a shorter time than a standard intravenous cannula performed intravascular access.