title: Intraosseous emergency access by physicians wearing full protective gear.
abstract: OBJECTIVE
  To assess prospectively and randomly the feasibility, speed, and success rate of establishing an intraosseous access using the Bone Injection Gun (BIG) while wearing antichemical outfits.
  
  
  METHODS
  Attempts to introduce intraosseous injection with or without a full protective gear (antichemical body suit, face mask, and butyl gloves) were performed using a turkey bone model. Time to proper placement was measured.
  
  
  RESULTS
  The average time to successfully insert the BIG's needle while wearing a protective gear was 32 +/- 3 seconds compared with 22 +/- 2 seconds (p<0.05) without the outfit. Success rate was greater than or equal to 80%. When failure occurred, a second attempt always proved successful.
  
  
  CONCLUSIONS
  The intraosseous insertion of the BIG's needle is rapid and easy but requires 50% more time when wearing protective gear than without it. Its use during emergent treatment of toxic mass casualty is of potential benefit and needs further investigation.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Ron
authors.initials: R
authors.lastname: Ben-Abraham
authors.forename: Ilan
authors.initials: I
authors.lastname: Gur
authors.forename: Youri
authors.initials: Y
authors.lastname: Vater
authors.forename: Avi A
authors.initials: AA
authors.lastname: Weinbroum
mesh_terms: D000818:Animals; D004632:Emergency Medical Services; D005240:Feasibility Studies; D006801:Humans; D017148:Infusions, Intraosseous; D007557:Israel; D010820:Physicians; D011446:Prospective Studies; D011482:Protective Devices; D013997:Time Factors; D014422:Turkeys