Effects of Intraosseous and Intravenous Administration of Hextend® on Time of Administration and Hemodynamics in a Swine Model

Effects of Intraosseous and Intravenous Administration of Hextend® on Time of Administration and Hemodynamics in a Swine Model

Bibliography

Name: Michael Bentley

Rank:

Presenter/Poster: Podium

Year: 2014

Abstract

Battlefield injuries resulting from Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) have reignited interest in practice guidelines regarding hemorrhage control and initial treatment. Casualties suffering from hemorrhagic injuries require reliable access through which they may receive resuscitative fluids. Combat care providers currently utilize two options on the battlefield to obtain access for resuscitation: the priority being intravenous followed by intraosseous cannulation. There is not sufficient evidence to support that the IV access is superior to the IO access during resuscitation.

The aim of this study was to determine if there were differences were found in hemodynamics when administering Hextend via the IO or the IV routes.

We evaluated hemodynamics and transfusion time when administering Hextend (6% Hydroxylethyl Starch) via the IO and IV routes in a swine hemorrhage model. Nineteen Sus scrofa Yorkshire-cross swine weighing between 67 and 80 kg were assigned to 3 groups: IO, IV and a control. Swine in the IV group had an 18-gauge IV catheter placed in the ear, and swine in the IO group had a 15-gauge EZ-IO needle placed in the tibia. Hextend was administered via the IO or IV groups and hemodynamics were measured at designated interval.     Using a MANOVA, no significant differences were found in hemodynamics when administering Hextend via the IO or the IV routes. As well, utilizing independent t-tests for comparison, there was no difference in time to infusion between the IV or IO routes.

Our findings strongly suggest that administration of Hextend through a tibial IO needle is an equal alternative to IV access without a statistically significant difference in hemodynamics or transfusion time.

Nurses should consider intraosseous cannulation for administration of Hextend in trauma settings. The clinical difficulties routinely encountered by experienced providers attempting intravenous cannulation during hypovolemic hemorrhagic shock can be minimized via the intraosseous cannulation technique. This method allows for faster intravascular fluid replacement, in less than 10 seconds, which is extremely important for combat care providers and first responders.

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