Brian Clemency1, Kaori Tanaka2, Paul May3, Johanna Innes4, Sara Zagroba5, Jacqueline Blaszak6, David Hostler7, Derek Cooney8, Kevin McGee9, Heather Lindstrom10. 1. Department of Emergency Medicine, University at Buffalo, University Emergency Medicine Services, 462 Grider Street, Buffalo, NY 14215, USA; American Medical Response (AMR), 481 William L. Gaiter Pkwy, Buffalo, NY 14215, USA. Electronic address: bc34@buffalo.edu. 2. Department of Emergency Medicine, University at Buffalo, University Emergency Medicine Services, 462 Grider Street, Buffalo, NY 14215, USA. Electronic address: ktanaka_0123@hotmail.com. 3. Department of Emergency Medicine, University at Buffalo, University Emergency Medicine Services, 462 Grider Street, Buffalo, NY 14215, USA. Electronic address: paulmay@buffalo.edu. 4. Department of Emergency Medicine, University at Buffalo, University Emergency Medicine Services, 462 Grider Street, Buffalo, NY 14215, USA. Electronic address: JohannaInnes@gmail.com. 5. Department of Emergency Medicine, University at Buffalo, University Emergency Medicine Services, 462 Grider Street, Buffalo, NY 14215, USA. Electronic address: vsarazagr@buffalo.edu. 6. Department of Emergency Medicine, University at Buffalo, University Emergency Medicine Services, 462 Grider Street, Buffalo, NY 14215, USA. Electronic address: jblaszak@buffalo.edu. 7. Department of Emergency Medicine, University at Buffalo, University Emergency Medicine Services, 462 Grider Street, Buffalo, NY 14215, USA; Department of Exercise and Nutrition Sciences, University at Buffalo, 211 Kimball Tower, Buffalo, NY 14214-8028, USA. Electronic address: dhostler@buffalo.edu. 8. American Medical Response (AMR), 481 William L. Gaiter Pkwy, Buffalo, NY 14215, USA; Department of Emergency Medicine, SUNY Upstate Medical University, 750 East Adams Street, Syracuse, NY 13210, USA. Electronic address: cooney@upstate.edu. 9. Department of Emergency Medicine, University at Buffalo, University Emergency Medicine Services, 462 Grider Street, Buffalo, NY 14215, USA. Electronic address: kmcgeedo@gmail.com. 10. Department of Emergency Medicine, University at Buffalo, University Emergency Medicine Services, 462 Grider Street, Buffalo, NY 14215, USA. Electronic address: HLindstrom@ecmc.edu.
Abstract
INTRODUCTION: Guidelines endorse intravenous (IV) and intraosseous (IO) medication administration for cardiac arrest treatment. Limited clinical evidence supports this recommendation. A multiagency, retrospective study was performed to determine the association between parenteral access type and return of spontaneous circulation (ROSC) in out of hospital cardiac arrest. METHODS: This was a structured, retrospective chart review of emergency medical services (EMS) records from three agencies. Data was analyzed from adults who suffered OHCA and received epinephrine through EMS established IV or IO access during the 18-month study period. Per regional EMS protocols, choice of parenteral access type was at the provider's discretion. Non-inferiority analysis was performed comparing the association between first access type attempted and ROSC at time of emergency department arrival. RESULTS: 1310 subjects met inclusion criteria and were included in the analysis. Providers first attempted parenteral access via IV route in 788 (60.15%) subjects. Providers first attempted parenteral access via IO route in 552 (39.85%) subjects. Rates of ROSC at time of ED arrival were 19.67% when IV access was attempted first and 19.92% when IO access was attempted first. An IO first approach was non-inferior to an IV first approach based on the primary end point ROSC at time of emergency department arrival (p=0.01). CONCLUSION: An IO first approach was non-inferior to an IV first approach based on the end point ROSC at time of emergency department arrival.
INTRODUCTION: Guidelines endorse intravenous (IV) and intraosseous (IO) medication administration for cardiac arrest treatment. Limited clinical evidence supports this recommendation. A multiagency, retrospective study was performed to determine the association between parenteral access type and return of spontaneous circulation (ROSC) in out of hospital cardiac arrest. METHODS: This was a structured, retrospective chart review of emergency medical services (EMS) records from three agencies. Data was analyzed from adults who suffered OHCA and received epinephrine through EMS established IV or IO access during the 18-month study period. Per regional EMS protocols, choice of parenteral access type was at the provider's discretion. Non-inferiority analysis was performed comparing the association between first access type attempted and ROSC at time of emergency department arrival. RESULTS: 1310 subjects met inclusion criteria and were included in the analysis. Providers first attempted parenteral access via IV route in 788 (60.15%) subjects. Providers first attempted parenteral access via IO route in 552 (39.85%) subjects. Rates of ROSC at time of ED arrival were 19.67% when IV access was attempted first and 19.92% when IO access was attempted first. An IO first approach was non-inferior to an IV first approach based on the primary end point ROSC at time of emergency department arrival (p=0.01). CONCLUSION: An IO first approach was non-inferior to an IV first approach based on the end point ROSC at time of emergency department arrival.
Authors: M Christ; K I von Auenmüller; T von den Benken; S Fessaras; W Dierschke; H-J Trappe Journal: Med Klin Intensivmed Notfmed Date: 2018-10-23 Impact factor: 0.840
Authors: Mohamud R Daya; Brian G Leroux; Paul Dorian; Thomas D Rea; Craig D Newgard; Laurie J Morrison; Joshua R Lupton; James J Menegazzi; Joseph P Ornato; George Sopko; Jim Christenson; Ahamed Idris; Purav Mody; Gary M Vilke; Caroline Herdeman; David Barbic; Peter J Kudenchuk Journal: Circulation Date: 2020-01-16 Impact factor: 29.690
Authors: Ming Chen; Yi Li; Xiang Huang; Ya Gu; Shang Li; Pengbin Yin; Licheng Zhang; Peifu Tang Journal: Bone Res Date: 2021-03-22 Impact factor: 13.567
Authors: Anika Grüneboom; Ibrahim Hawwari; Daniela Weidner; Stephan Culemann; Sylvia Müller; Sophie Henneberg; Alexandra Brenzel; Simon Merz; Lea Bornemann; Kristina Zec; Manuela Wuelling; Lasse Kling; Mike Hasenberg; Sylvia Voortmann; Stefanie Lang; Wolfgang Baum; Alexandra Ohs; Oliver Kraff; Harald H Quick; Marcus Jäger; Stefan Landgraeber; Marcel Dudda; Renzo Danuser; Jens V Stein; Manfred Rohde; Kolja Gelse; Annette I Garbe; Alexandra Adamczyk; Astrid M Westendorf; Daniel Hoffmann; Silke Christiansen; Daniel Robert Engel; Andrea Vortkamp; Gerhard Krönke; Martin Herrmann; Thomas Kamradt; Georg Schett; Anja Hasenberg; Matthias Gunzer Journal: Nat Metab Date: 2019-01-21
Authors: Kate McKenzie; Saoirse Cameron; Natalya Odoardi; Katelyn Gray; Michael R Miller; Janice A Tijssen Journal: Front Pediatr Date: 2022-02-22 Impact factor: 3.418