Intraosseous Vascular Access in Radiology: Review of Clinical Status

Baadh, Amanjit S.; Singh, Ayushi; Choi, Andrew; Baadh, Palvir K.; Katz, Douglas S.; Harcke, H. Theodore

doi:10.2214/ajr.15.15784

Cited by 19 publications

(29 citation statements)

References 28 publications

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“…Furthermore, it is promising that in this series no untoward event related to CMI via ION-IVA was observed. As this and similar evidence 4 , 8 – 10 related to the safety of ION-IVA for CMI mounts, personnel may be less reluctant to use ION-IVA for this indication.…”

Section: Discussionmentioning

confidence: 66%

“…3 ) for using ION-IVA for CMI. As this and other algorithms 4 are promulgated via the medical literature, training in the use ION-IVA for CTA-TA may become routine. Furthermore, it is promising that in this series no untoward event related to CMI via ION-IVA was observed.…”

Section: Discussionmentioning

confidence: 99%

“…A recent clinical review by Baadh et al calls for imaging physicians to familiarize themselves with the technique of using ION-IVA for CMI. 4 There is a substantial body of mid twentieth century literature, predating the advent of computed tomography, reporting the safe use of ION-IVA for CMI during fluoroscopic venography studies. 5 Fairly recent data on the safe use of ION-IVA for CMI from animal models has also been published.…”

Section: Introductionmentioning

confidence: 99%

“… 6 , 7 However, modern literature reporting the clinical use of ION-IVA for CTA-TA is sparse. 4 , 8 – 10 The objective of this study was to retrospectively survey the safety of ION-IVA CMI performed during CTA-TA and to assess the quality of the resultant exams.…”

Section: Introductionmentioning

confidence: 99%

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The use of intraosseous needles for injection of contrast media for computed tomographic angiography of the thoracic aorta

Winkler

Talley

Woodward

et al. 2017

Journal of Cardiovascular Computed Tomography

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BackgroundThe objective of this study is to evaluate the safety and quality of computed tomographic angiography of the thoracic aorta (CTA-TA) exams performed using intraosseous needle intravenous access (ION-IVA) for contrast media injection (CMI).MethodsAll CTA-TA exams at the study institution performed between 1/1/2013 and 8/14/2015 were reviewed retrospectively to identify those exams which had been performed using ION-IVA (ION-exams). ION-exams were then analyzed to determine aortic attenuation and contrast-to-noise ratio (CNR). Linear regression was used to determine how injection rate and other variables affected image quality for ION-exams. Patient electronic medical records were reviewed to identify any adverse events related to CTA-TA or ION-IVA.Results17 (~0.2%) of 7401 exams were ION-exams. ION-exam CMI rates varied between 2.5 and 4 ml/s. Mean attenuation was 312 HU (SD 88 HU) and mean CNR was 25 (SD 9.9). A strong positive linear association between attenuation and injection rate was found. No immediate or delayed complications related to the ION-exams, or intraosseous needle use in general, occurred.ConclusionFor CTA-TA, ION-IVA appears to be a safe and effective route for CMI at rates up to 4 ml/s.

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Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The use of intraosseous needles for injection of contrast media for computed tomographic angiography of the thoracic aorta

Winkler

Talley

Woodward

et al. 2017

Journal of Cardiovascular Computed Tomography

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“…Tal eficácia se dá porque os vasos intramedulares e os lagos venosos estão envoltos por paredes ósseas firmes e que não são colabáveis, mantendo-se pérveas, mesmo nos casos de parada cardíaca e choques 7 . A utilidade seu uso tem sido comprovado em emergência de adultos, pediatria, e situações militares 3,7,8 , bem como em não-emergências, quando o acesso vascular não pode ser obtido, ou quando o paciente pode estar em risco de aumento da morbidade ou mortalidade, além de ocasiões como no período perioperatório (9). A técnica costuma ser de fácil execução e bem sucedida em 90-95% dos casos em que é indicada 10,11 .…”

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Limitação Da Utilização Do Acesso Intraósseo: Aspectos Da Enfermagem E Da Instituição De Saúde

Schumaher

Jara

Bóbbo

et al. 2018

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Objetivo: Verificar a realização do acesso intraósseo por enfermeiros. Método: Estudo analítico transversal, realizado por meio da aplicação de um questionário. Resultados: Demonstrou-se que 97,0% dos profissionais nunca realizaram o acesso (p<0,001), e 48,5% tiveram um treinamento adequado. Apenas 9,1% relatou se sentir seguro para executar a técnica (p<0,001) e 69,7% responderam que não possuem apoio técnico, e não possuem material apropriado. Conclusão: Demonstrou-se que existe uma limitação do uso do acesso intraósseo. A falta de autonomia para realizar a técnica pode se explicar pela falta de habilidade prática e conhecimento teórico dos enfermeiros, e pela falta de protocolos e acesso à informações institucionais, treinamentos e insumos.Descritores: Infusões Intraósseas; Enfermagem; Desenvolvimento de pessoal. LIMITATION OF THE USE OF INTRAÓSSEO ACCESS: ASPECTS OF NURSING AND HEALTH INSTITUTIONAim: To verify the achievement of intraosseous access by nurses. Method: Cross-sectional analytical study, carried out through the application of a questionnaire. Results: It was demonstrated that 97,0% of the professionals never performed access (p <0.001), and 48,5% had adequate training. Only 9,1% reported feeling safe to perform the technique (p <0.001) and 69,7% answered that they do not have technical support, and do not have appropriate material. Conclusion: It has been demonstrated that there is a limitation of the use of intraosseous access. The lack of autonomy to perform the technique can be explained by the lack of practical skills and theoretical knowledge of nurses, and the lack of protocols and access to institutional information, training and inputs. Descriptors: Intraosseous infusions; Nursing; Development of personnel. ACCESO LIMITACIÓN DE USO INTRAÓSEA: ASPECTOS DE LA ENFERMERÍA Y INSTITUCIÓN DE SALUD.Objetivo: Verificar la realización del acceso intraóseo para las enfermeras. Método: Estudio transversal analítico realizado mediante la aplicación de un cuestionario. Resultados: Se demostró que 97,0% de los encuestados nunca hizo de acceso (p <0,001), y 48,5% tenía una formación adecuada. Sólo 9.1% reportó sentirse seguro para llevar a cabo la técnica (p <0,001) y 69,7% dijeron que no tienen soporte, y no tienen ningún material adecuado. Conclusión: Se ha demostrado que existe una limitación del uso de la vía intraósea. La falta de autonomía para llevar a cabo la técnica puede explicarse por la falta de habilidades prácticas y conocimientos teóricos de las enfermeras, y la falta de protocolos y el acceso a la información institucional, la capacitación y los insumos. Descriptores: Infusiones intraóseas; enfermería; desarrollo del personal. Enferm. Foco 2018; 9 (2): 44-50

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Applied anatomy for tibial intraosseous access in adults

et al. 2017

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Intraosseous access is a method for providing vascular access in resuscitation of critically ill and injured patients when traditional intravenous access is difficult or impossible. There is a lack of detailed description for the landmark for the insertion point in the literature. The aim of this study was to determine the exact location for intraosseous access. Radiographic computed tomography (CT) images of a total of 50 dry tibia bones were obtained. With 5-mm intervals, for all transverse images and by selecting transverse section, measurements were taken from the thickness of the cortex at anterior margin and mid-line medial surface, distance from anterior margin, and mid-line medial surface of the tibia to the posterior wall of medullar cavity, distance from anterior margin and mid-line medial surface of the tibia to the posterior surface of the tibia. The thinner part of the cortex of the tibia and the larger width of the medullar cavity is at 0.5 cm below the tibial tuberosity in the midline of the medial surface. The application region for proximal tibia access and landmark and most suitable insertion point for intraosseous infusion should be at level 0.5 cm below the tibial tuberosity in the midline of the medial surface. It was recommended that standard length for intraosseous canule should be 17 mm except for the thickness of skin. In conclusion, presented study provides certain localization for intraosseous access and standard length for intraosseous canule and this will be more effective in using this technique. Clin. Anat. 31:593-597, 2018. © 2017 Wiley Periodicals, Inc.

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Intraosseous Vascular Access in Radiology: Review of Clinical Status

Abstract: We present a protocol for the administration of iodinated contrast media through the intraosseous route. We also highlight the clinical and radiologic aspects of intraosseous access.

Cited by 19 publications

References 28 publications

The use of intraosseous needles for injection of contrast media for computed tomographic angiography of the thoracic aorta

The use of intraosseous needles for injection of contrast media for computed tomographic angiography of the thoracic aorta

Limitação Da Utilização Do Acesso Intraósseo: Aspectos Da Enfermagem E Da Instituição De Saúde

Applied anatomy for tibial intraosseous access in adults

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