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Quality in Emergency Department Care: Results of the Sullivan Group's Emergency Medicine Risk Initiative National Audit by J.W. Hafner Jr.; J.R. Hubler; D.J. Sullivan is a Medicine article available to read on EtoBox.

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Study Objectives: To confirm placement and assess leakage after intraosseous needle placement (INP) using ultrasound/Color Flow Doppler (US/CFD). Methods: Porcine legs were harvested postmortem. The INP operator placed the needle and recorded it as ''IN'' or ''OUT'' of bone. Without touching the INP, a blinded US/CFD operator using a 10Mhz probe looked for a bony defect, a ''ringdown'' sign or a echo dense foreign body. CFD was used (3 cm depth) when 10 CC of saline was infused through the INP. US findings were classified as ''IN'' or ''OUT'' of bone or ''INDETERMINATE'' (no flow observed). Each INP into bone was dissected to verify location. Results: A complete ''flush'' of the CFD field is associated with flow into the muscle and fascia. Local areas of flow within the field are associated with placement into bone. Three needles that were firmly seated in bone (''IN'') were considered ''OUT'' by US/CFD. On dissection, the flush was caused by a needle tip that exited the bone or leakage at the insertion site. N=34. Four ''IN'' were indeterminate by US. 9/11 correctly identified as being '' IN'': 17/19 correctly identified as ''OUT''. Sen 81.8% (0.523,0949). Spec 89.5% (0.686,0.971)

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Author

J.W. Hafner Jr.; J.R. Hubler; D.J. Sullivan

Publisher

Elsevier Science; Elsevier ; Mosby Inc.; Elsevier BV (ISSN 1097-6760)

Published

2005

Language

EN

Field

Medicine (Health Sciences)