Re-Emphasis on Bone Marrow as a Medium for Administration of Fluid

Pillar, Samuel

doi:10.1056/nejm195411182512103

Cited by 20 publications

(4 citation statements)

References 6 publications

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“…Thus, infused fluids such as NaOCl will be rapidly transported to the central veins of the body, 92–94 and have similar effects as those obtained by intravenous injection directly into the peripheral vascular system. 95 This concept provides the rationale for the adoption of intraosseous vascular access for in pre-hospital settings or in-hospital emergencies for administering drugs to patients suffering from shock and trauma, wherein collapse of the peripheral veins preclude the use of venipuncture or even venesection. 96–100 Based on the same principles, intraosseous anesthesia is employed in dentistry as a supplementary technique for obtaining rapid, profound pulpal anesthesia when this cannot be achieved via conventional infiltration or block anesthesia.…”

Section: Intravenous Infusion Of Naoclmentioning

confidence: 99%

Anatomy of sodium hypochlorite accidents involving facial ecchymosis—A review

Zhu

Gyamfi

Niu

et al. 2013

Journal of Dentistry

109

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Objectives Root canal treatment forms an essential part of general dental practice. Sodium hypochlorite (NaOCl) is the most commonly used irrigant in endodontics due to its ability to dissolve organic soft tissues in the root canal system and its action as a potent antimicrobial agent. Although NaOCl accidents created by extrusion of the irrigant through root apices are relatively rare and are seldom life-threatening, they do create substantial morbidity when they occur. Methods To date, NaOCl accidents have only been published as isolated case reports. Although previous studies have attempted to summarise the symptoms involved in these case reports, there was no endeavor to analyse the distribution of soft tissue distribution in those reports. In this review, the anatomy of a classical NaOCl accident that involves facial swelling and ecchymosis is discussed. Results By summarising the facial manifestations presented in previous case reports, a novel hypothesis that involves intravenous infusion of extruded NaOCl into the facial vein via non-collapsible venous sinusoids within the cancellous bone is presented. Conclusions Understanding the mechanism involved in precipitating a classic NaOCl accident will enable the profession to make the best decision regarding the choice of irrigant delivery techniques in root canal débridement, and for manufacturers to design and improve their irrigation systems to achieve maximum safety and efficient cleanliness of the root canal system.

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Section: Intravenous Infusion Of Naoclmentioning

confidence: 99%

Anatomy of sodium hypochlorite accidents involving facial ecchymosis—A review

Zhu

Gyamfi

Niu

et al. 2013

Journal of Dentistry

109

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“…These were generally self-limiting and did not require intervention (Massey, 1950). Extensive tissue damage due to the subcutaneous extravasation of norepinephrine administered through a dislodged IO needle was described by Pillar (1954) as early as 1954. Since that time, many other cases of soft tissue or bony necrosis have been identified due to IO extravasation of high volumes of catecholamines or hypertonic solutions of saline, glucose and bicarbonate (Wallden and Lennart, 1947; Spivey, 1987; Christensen et al, 1991; Ellemunter, 1999; Alam et al, 2002; Khan et al, 2011).…”

Section: Complicationsmentioning

confidence: 99%

“…A more complete understanding of how different IO medications affect not only their own distribution, but subsequent administrations of medications is essential. The use of hypertonic solutions for IO resuscitation is compelling due to the lower volumes of fluid needed to obtain a physiological effect, but animal studies have shown very mixed results in regards to their safety and the adverse outcomes associated with their extravasation into the soft tissues (Pillar, 1954; Spivey, 1987; Alam et al, 2002).…”

Section: Future Researchmentioning

confidence: 99%

Intraosseous vascular access: A review

Paxton

2012

Trauma

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Intraosseous cannulation is an increasingly common means of achieving vascular access for the administration of fluids and medications during the emergent resuscitation of both paediatric and adult patients. Improved tools and techniques for intraosseous vascular access have recently been developed, enabling the healthcare provider to choose from a wide range of devices and insertion sites. Despite its increasing popularity within the adult population, and decades of use in the paediatric population, questions remain regarding the safety and efficacy of intraosseous infusion. Although various potential complications of intraosseous cannulation have been theorized, few serious complications have been reported. This article aims to provide a review of the current literature on intraosseous vascular access, including discussion on the various intraosseous devices currently available in the market, the advantages and disadvantages of intraosseous access compared to conventional vascular access methods, complications of intraosseous cannulation and current recommendations on the use of this approach.

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“…This has obvious advantages in clinical practice. (Getschman et al, 1994;Friedman, 1996) 2 Ephedrine (Shoor et al, 1979) 2 Adrenaline (Shoor et al, 1979;Orlowski, 1990) 2 Heparin (Valdes, 1977;Orlowski, 1990) 2 Ampicillin (McNamara et al, 1987;Mofenson et al, 1988) 2 Insulin (Tocantins, 1940) 2 Antitetanus serum (Heinild et al, 1947) 2 Lignocaine (Valdes, 1977;Orlowski, 1990) 2 Atropine (Prete et al, 1986;Katan et al, 1988) 2 Lorazepam (Jim et al, 1989) 2 Atracurium (Selby and James, 1993) 2 Mannitol (Guy et al, 1993) 2 Bretylium (Glaeser et al, 1993) 2 Midazolam (Selby and James, 1993) 2 Calcium chloride (Orlowski, 1990) 2 Morphine (Macht, 1941;Guy et al, 1993) 2 Chlortetracycline (Pillar, 1954) 2 Naloxone (Glaeser et al, 1993) 2 Dexamethasone (Valdes, 1977) 2 Pancuronium (Smith et al, 1988) 2 Dextrose 50% (Neish et al, 1988;Orlowski, 1990) 2 Penicillin (Tarrow, 1952) 2 Diazepam (Spivey, 1985;Brickman, 1987) 2 Phenobarbitone (Brickman, 1987) 2 Diazoxide (Valdes, 1977) 2 Phenytoin (Zimmerman et al, 1989) 2 Digoxin (Mofenson et al, 1988) 2 Suxamethonium (Katan et al, 1988;Selby and James, 1993) 2 Dobutamine (Berg, 1984;Biello et al, 1991) 2 Thiopentone…”

Section: Intraosseous Administration Of Drugsmentioning

confidence: 99%

Intraosseous infusions in the adult

Greaves

Evans

Boyle

1999

Trauma

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Intraosseous infusions are used in children when intravenous access is difficult or impossible. The intraosseous route is also applicable to adults, but is not widely used. In this article, the anatomy and physiology of bone marrow is described and techniques and sites of intraosseous needle placement are discussed. Fluid and drug administration by the intraosseous route is also discussed. Intraosseous anaeasthesia and diagnostic testing is possible through intraossoeous needles. Potential complications and contraindications are considered.

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Re-Emphasis on Bone Marrow as a Medium for Administration of Fluid

Cited by 20 publications

References 6 publications

Anatomy of sodium hypochlorite accidents involving facial ecchymosis—A review

Anatomy of sodium hypochlorite accidents involving facial ecchymosis—A review

Intraosseous vascular access: A review

Intraosseous infusions in the adult

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