title: Intraosseous access in trauma by air medical retrieval teams.
abstract: Trauma accounts for a significant portion of overall mortality globally. Hemorrhage is the second major cause of mortality in the prehospital environment. Air medical retrieval services throughout the world have been developed to help improve the outcomes of patients suffering from a broad range of medical conditions, including trauma. These services often utilize intraosseous (IO) devices as an alternative means for access of both medically ill and traumatically injured patients in austere environments. However, studies have suggested that IO access cannot reach acceptable rates for massive transfusion. We review the subject to find the answer of whether IO access should be performed by air medical teams in the prehospital setting, or would central venous (CVC) access be more appropriate? We decided to assess the literature for capacity of IO access to meet resuscitation requirements in the prehospital management of trauma. We also decided to compare the insertion and complication characteristics of IO and CVC access.
authors: CareFlight, Darwin, NT Australia.
authors: Mark
authors: M
authors: Sheils
authors: CareFlight, Darwin, NT Australia.
authors: Mark
authors: M
authors: Ross
authors: CareFlight, Darwin, NT Australia.
authors: Noel
authors: N
authors: Eatough
authors: CareFlight, Darwin, NT Australia; Department of Emergency Medicine, Lincoln Medical and Mental Health Center Bronx, NY, USA. Electronic address: ncaputo.md@gmail.com.
authors: Nicholas D
authors: ND
authors: Caputo
mesh_terms: D017732:Air Ambulances; D002405:Catheterization, Central Venous / Q000009:adverse effects; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D007022:Hypotension / Q000209:etiology / Q000628:therapy*; D017148:Infusions, Intraosseous / Q000009:adverse effects / Q000379:methods; D012151:Resuscitation / Q000379:methods*; D012771:Shock, Hemorrhagic / Q000209:etiology / Q000628:therapy*; D013997:Time Factors; D014947:Wounds and Injuries / Q000150:complications