title: Evaluation of a new pediatric intraosseous needle insertion device for low-resource settings.
abstract: OBJECTIVE
  The Near Needle Holder (NNH) (Near Manufacturing, Camrose, Alberta, Canada) is a reusable tool to introduce a standard hollow needle for pediatric intraosseous (IO) infusion. We compared the NNH to the Cook Dieckmann (Cook Critical Care, Bloomington, IN) manual IO needle in a simulation setting.
  
  
  METHODS
  Study subjects were 32 physicians, nurses, and medical students participating in a trauma course in Guyana. After watching a training video and practicing under supervision, subjects were observed inserting each device into a pediatric leg model using a randomized crossover design. Outcome measures were time to successful insertion, technical complications, ease of use, and safety of each device.
  
  
  RESULTS
  The mean time for IO insertion (32 ± 13 seconds) was similar for both devices (P = .92). Subjects rated the NNH device equivalent in ease of use to the Cook IO needle but slightly lower in perceived safety to the user.
  
  
  CONCLUSIONS
  After training, all subjects successfully inserted the NNH IO device in a simulation environment, and most rated it as easy to use and safe. The NNH is a significant advance because IO needles are often not available in emergency departments in developing countries. Further studies are needed to evaluate clinical effectiveness of the NNH.
authors.affiliation: McMaster International Surgery Desk, Hamilton, Canada.
authors.forename: Sara
authors.initials: S
authors.lastname: Kalechstein
authors.forename: Ahiliyia
authors.initials: A
authors.lastname: Permual
authors.forename: Blair M
authors.initials: BM
authors.lastname: Cameron
authors.forename: Julia
authors.initials: J
authors.lastname: Pemberton
authors.forename: Gwen
authors.initials: G
authors.lastname: Hollaar
authors.forename: Deirdre
authors.initials: D
authors.lastname: Duffy
authors.forename: Brian H
authors.initials: BH
authors.lastname: Cameron
mesh_terms: D001291:Attitude of Health Personnel; D002648:Child; D018592:Cross-Over Studies; D003906:Developing Countries; D017743:Equipment Reuse; D006172:Guyana; D006801:Humans; D017148:Infusions, Intraosseous / Q000295:instrumentation*; D008953:Models, Anatomic; D009339:Needles; D010372:Pediatrics / Q000193:education / Q000295:instrumentation*; D014743:Videotape Recording