title: Evaluation of the sternal intraosseous route as alternative emergency vascular access for the dental office: a manikin and cadaver model pilot study.
abstract: OBJECTIVE
  To evaluate 2 sternal intraosseous access devices as alternatives to emergency intravenous access for dentists, using a manikin and a cadaver model.
  
  
  METHODS
  A group of 37 students performed a sternal intraosseous access on a manikin using a Vidacare kit including a puncture template and a prepuncture skin incision. Five months later, 9 of the students used the Vidacare and 8 used an Illinois needle (without template and incision) on adult human cadavers. India ink was injected as a tracer.
  
  
  RESULTS
  Shorter times were recorded on cadavers compared with manikins in both systems. One Vidacare puncture ended subcutaneously. Two Illinois needle punctures perforated the sternum, one with intense mediastinal ink traces. Vidacare punctures took longer compared with Illinois needle punctures (medians, 32 vs 12 seconds; P = .0002).
  
  
  CONCLUSIONS
  Template use to identify the sternal puncture position, combined with additional prepuncture skin incision, may be more efficient and less predisposed to severe complications for dentists' emergency use.
authors.affiliation: University of Heidelberg, Institute for Anatomy and Cell Biology, Heidelberg, Germany.
authors.forename: Lara
authors.initials: L
authors.lastname: Erdmann
authors.forename: Sara
authors.initials: S
authors.lastname: Doll
authors.forename: Brit
authors.initials: B
authors.lastname: Ihle
authors.forename: Joachim
authors.initials: J
authors.lastname: Kirsch
authors.forename: Till S
authors.initials: TS
authors.lastname: Mutzbauer
mesh_terms: D000328:Adult; D002102:Cadaver; D003770:Dental Offices; D004497:Education, Dental; D004521:Educational Measurement; D004638:Emergency Treatment; D004867:Equipment Design; D006801:Humans; D017148:Infusions, Intraosseous / Q000295:instrumentation / Q000379:methods*; D008348:Manikins; D009339:Needles; D010865:Pilot Projects; D011677:Punctures; D013249:Sternum; D013997:Time Factors