Intraosseous vascular access is safe, effective and costs less than central venous catheters for patients in the hospital setting
J Vasc Access 2013; 14(3): 216 - 224
Article Type: ORIGINAL ARTICLE
DOI:10.5301/jva.5000130
Authors
Michael Dolister, Stephen Miller, Stephen Borron, Edward Truemper, Manoj Shah, Muriel R. Lanford, Thomas E. Philbeck
Abstract
Purpose: Central venous catheters (CVCs) are often placed to resuscitate unstable emergency department (ED) patients. In an observational study, we assessed intraosseous (IO) vascular access in the hospital, and compared results to published experiences with CVC placement.
Methods: Patients who would typically receive a CVC were considered for the study. Vascular access was gained using a powered IO device. Data collection included placement success, placement time, ease-of-use, satisfaction with flow rates, complications and subsequent CVC placement.
Results: A total of 105 cases were studied from six centers. Mean age was 48.0±28.0 years and 53% were men; 85% of the patients were medical cases, and 53% were in cardiac/respiratory arrest. Of those, 48% returned to spontaneous circulation. A total of 94% of placements were successful on the first attempt. Mean time to IO access was 103.6±96.2 seconds. There was one serious complication – a lower extremity compartment syndrome. IO access costs $100/patient.
Conclusions: The data revealed faster and more successful IO catheter placement than reported for CVCs, few complications and high user satisfaction. For simple placements, cost savings for IO access vs. CVCs was $195/procedure. If 20% of the 3.5 million CVCs placed annually were replaced with IO catheters, cost savings could approach $650 million/year. We conclude that IO access in place of CVCs delivers high value in terms of being a safe, fast and effective mode of vascular access for patients in the hospital setting, with potentially substantial cost savings. These data indicate that IO access is a cost effective and viable alternative to problematic CVC lines.
Article History
- • Accepted on 06/11/2012
- • Available online on 03/01/2013
- • Published in print on 01/10/2013
This article is available as full text PDF.
Authors
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Dolister, Michael [PubMed] [Google Scholar]
Gulf Breeze Hospital, Baptist Hospital, Pensacola, FL - USA
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Miller, Stephen [PubMed] [Google Scholar]
Methodist University Hospital, University of Tennessee Health Science Center, Memphis, TN - USA
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Borron, Stephen [PubMed] [Google Scholar]
University of Texas Tech Health Science Center El Paso, El Paso, TX - USA
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Truemper, Edward [PubMed] [Google Scholar]
Children’s Hospital and Medical Center, Omaha, University of Nebraska Health Science Center, Omaha, NE - USA
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Shah, Manoj [PubMed] [Google Scholar]
Advocate Lutheran General Hospital, Park Ridge, IL - USA
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Lanford, Muriel R. [PubMed] [Google Scholar]
Vidacare Corporation, Shavano Park, TX - USA
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Philbeck, Thomas E. [PubMed] [Google Scholar]
Vidacare Corporation, Shavano Park, TX - USA
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