The use of alternative vascular access in emergency care

master's thesis

• Title (croatian): Upotreba alternativnog vaskularnog pristupa u hitnoj pomoći
• Author: Máté Huba Huszár
• Mentor: Vesna Degoricija (mentor)
• Committee member: Vesna Degoricija (predsjednik povjerenstva)
• Committee member: Ivan Gornik (član povjerenstva)
• Committee member: Boško Skorić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2023-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

A variety of alternative emergency vascular access solutions have been tested and described in the literature. In cases of difficult intravenous access (DIVA) in emergency settings, intraosseous access (IO) has consistently been suggested by professional organisations as the most suitable alternative to peripheral venous catheters (PVC) due to its proven superiority. IO is the quickest and safest option when immediate intravenous access cannot be established.

This thesis, as a descriptive cross-sectional study, presents structured survey data about IO utilisation in the city- and county of Zagreb. The participants were licensed healthcare professionals of emergency departments and pre-hospital emergency medical services (EMS). Findings indicate that IO access is not being used to its full potential due to a lack of sufficient awareness, equipment, training, and fear of use. Most of the respondents (85%) experienced at least a few DIVAs in emergency situations during the recall period, and over 82% believed that at least some of their patients would have benefited from earlier vascular access. However, more than half of the participating practitioners have never thought of placing an IO, and only 9% have inserted one during the prior six months. Those who considered an IO but did not place one (37%) indicated lack of availability (42%), fear of use (17%) and lack of training (12%) as the most common reasons.

Various measures could be implemented to encourage the use of IO access in emergencies, such as improving training programmes, ensuring continuous availability, and introducing monitoring and quality assurance mechanisms.

Abstract (croatian)

U literaturi su testirani i opisani različiti alternativni hitni vaskularni pristupi. U slučajevima otežanog intravenskog pristupa u hitnim situacijama, profesionalne organizacije predlažu intraosealni (IO) pristup kao najprikladniju alternativu perifernim venskim kateterima zbog njegove dokazane superiornosti. IO pristup je najbrža i najsigurnija opcija kada se u kritičnom trenutku ne može uspostaviti trenutni intravenski pristup.

Ovaj diplomski rad, kao deskriptivna presječna studija, predstavlja strukturirane anketne podatke o korištenju IO pristupa u gradu Zagrebu i Zagrebačkoj županiji. Sudionici su bili licencirani zdravstveni djelatnici hitne službe i predbolničke hitne medicinske pomoći. Rezultati pokazuju da se IO pristup ne koristi u punom potencijalu zbog nedostatka svjesnosti, opreme, obuke i straha od korištenja. Većina ispitanika (85%) doživjela je barem nekoliko hitnih situacija u kojima je postavljanje intravenskog katetera bilo otežano, a preko 82% vjeruje da bi barem neki od njihovih bolesnika imali koristi od ranije uspostavljenog vaskularnog pristupa. Međutim, više od polovice ispitanika nikada nije razmišljalo o postavljanju IO pristupa, a samo 9% ga je koristilo tijekom prethodnih šest mjeseci. Oni koji su razmatrali IO pristup, ali ga nisu postavili (37%) naveli su nedostatak dostupnosti opreme (42%), strah od korištenja (17%) i nedostatak obuke (12%) kao najčešće razloge.

Različite mjere mogle bi se provesti kako bi se potaklo korištenje IO pristupa u hitnim slučajevima, poput poboljšanja programa obuke, osiguravanja stalne dostupnosti opreme te uvođenja mehanizama praćenja i osiguranja kvalitete provedbe.

• Keywords: Intraosseous access; infusions; intraosseous; IO; Vascular access; Emergency medicine
• Keywords (croatian): Intraosealni pristup; infuzije; intraosealne; IO; vaskularni pristup; hitna medicina
• Language: english
• URN:NBN: urn:nbn:hr:105:873622
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-09-01 10:47:21