Adult intraosseous infusion in accident and emergency departments in the UK

Abstract

Obective-A postal survey was conducted to gain an overview of current opinion and practice relating to intraosseous infusion in adult resuscitation in accident and emergency (A&E) departments in the UK and to use the results to generate debate in light of published and personal experience. Methods-Questionnaires were sent to 559 departments listed in the 1996 British Association for Accident and Emergency Medicine directory. Three hundred and thirty two (59%) were returned and the 157 (28%) consultant led departments with more than 30 000 new patient attendances per year were examined. Results-Seventy four per cent of respondents were aware that intraosseous infusion could be used in adult resuscitation, while only seven per cent used the technique. All (100%) were involved with training their medical staV and 11% said they taught the technique for use in adults. The majority of respondents were accredited in at least one of the adult resuscitation training courses. Conclusions-Numerous references appear in the literature relating to intraosseous infusion in adult resuscitation and represent a wealth of experience. The technique is taught and used in our department in contrast with the results of this survey, which demonstrate that it is infrequently taught and used in UK A&E departments. The more widespread teaching of this technique for adult use is recommended. (J Accid Emerg Med 2000;17:29-32)

Use of intraosseous devices in trauma: a survey of trauma practitioners in Canada, Australia and New Zealand

“…25 This finding suggests there is a need for improved device insertion education. In 1999, Lavis and colleagues 26 surveyed members of the British Association for Accident and Emergency Physicians on their familiarity with and use of IO devices. While 74% responded they were aware that IO devices could be used in adult resuscitation, only 7% reported using the technique.…”

“…While 74% responded they were aware that IO devices could be used in adult resuscitation, only 7% reported using the technique. 26 James Cheung and colleagues 27 performed an electronic survey of residents and attending physicians from a variety of specialties at a Canadian hospital in an effort to uncover barriers and facilitators to IO placement in adult resuscitations when peripheral IVs could not be achieved. They concluded that in order to increase IO use, future educational interventions should address physicians' attitudinal, normative and control beliefs.…”

The Efficacy of Intraosseous Blood and Ringer Lactate in a Rabbit Model of Hemorrhagic Hypovolemia

“…While a UK survey, performed in 1996, found IO equipment in only 7% of emergency departments (ED), a 2009 survey in Denmark found that 95% of ED personnel knew about IO lines, but only 48% had received training [25][26]. In this latter study, an average of five IO lines were placed per month per ED surveyed.…”

Barriers and Facilitators to Intraosseous Access in Adult Resuscitations When Peripheral Intravenous Access Is Not Achievable

“…Hospital and specialty society endorsement may additionally help to promote more widespread teaching of the technique among physicians. 10,38 Future research should be targeted at the implementation and evaluation of these interventions to determine their effect on increasing the appropriate utilization of IO access.…”

“…1 In addition, several European studies suggest that IO is infrequently used by physicians when indicated in adult resuscitations. [10][11][12] To develop interventions to increase the appropriate use of this potentially life-saving technique in adult resuscitations, a better understanding of the barriers and facilitators to IO access use by physicians is required.…”