Comparison of Umbilical Venous and Intraosseous Access During Simulated Neonatal Resuscitation
Comparison of Umbilical Venous and Intraosseous Access During Simulated Neonatal Resuscitation
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DOI：
10.1542/peds.2011-0657
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发表时间：
2011-10-01
期刊：
影响因子：
8
通讯作者：
Halamek, Louis P.
中科院分区：
文献类型：
--
作者：
Rajani, Anand K.;Chitkara, Ritu;Halamek, Louis P.
目的：紧急脐静脉导管（UVC）放置持续性心动过缓在产房是一种罕见的发生，需要显着的技能，并涉及空间限制。在新生儿中放置骨内针（ION）已得到充分描述。ION已用于儿科人群，并放置在远离胸外按压的解剖位置。在这项研究中，我们比较了放置时间，错误的位置，并认为易于使用的UVCs和离子在一个模拟的delivery room.SUBJECTS和METHODS：40医疗保健提供者被招募。向受试者展示了这两种技术的教学视频，并允许他们练习放置。受试者参加了2次需要静脉注射肾上腺素的模拟新生儿复苏。在一种情况下，他们需要放置UVC，而在另一种情况下，他们需要放置ION。场景被记录下来，用于以后的放置时间和错误率的分析。受试者进行了调查，关于每一个techniques.RESULTS的难度的感知水平：平均时间为离子放置比UVC放置快46秒（P <0.001）。有没有显着差异，在UVC和ION的位置之间的错误数量或在感知易用性use.CONCLUSIONS：在模拟产房设置，ION的位置可以更快地进行比UVC插入没有任何差异的技术错误率或感知易用性。当新生儿出生时需要快速静脉通路时，应考虑离子插入，特别是由不常规放置UVC的医疗保健专业人员。儿科2011;128：e954-e958
OBJECTIVE: Emergent umbilical venous catheter (UVC) placement for persistent bradycardia in the delivery room is a rare occurrence that requires significant skill and involves space constraints. Placement of an intraosseous needle (ION) in neonates has been well described. The ION is already used in the pediatric population and is placed at an anatomic location distant from where chest compressions are performed. In this study we compared time to placement, errors in placement, and perceived ease of use for UVCs and IONs in a simulated delivery room.SUBJECTS AND METHODS: Forty health care providers were recruited. Subjects were shown an instructional video of both techniques and allowed to practice placement. Subjects participated in 2 simulated neonatal resuscitations requiring intravenous epinephrine. In 1 scenario they were required to place a UVC and in the other an ION. Scenarios were recorded for later analysis of placement time and error rate. Subjects were surveyed regarding the perceived level of difficulty of each technique.RESULTS: The average time required for ION placement was 46 seconds faster than for UVC placement (P < .001). There was no significant difference in the number of errors between UVC and ION placement or in perceived ease of use.CONCLUSIONS: In a simulated delivery room setting, ION placement can be performed more quickly than UVC insertion without any difference in technical error rate or perceived ease of use. ION insertion should be considered when rapid intravenous access is required in the neonate at the time of birth, especially by health care professionals who do not routinely place UVCs. Pediatrics 2011;128:e954-e958