A patient with no access had a cardiac arrest in the field, aka OHCA (outside of hospital cardiac arrest).
Our trusty EMS (emergency medical services) teams who we all really appreciate show up at the scene.
Access to administer life-saving medications need to be obtained.
Should they attempt to obtain IV (intravenous) access?
Or should they attempt to obtain IO (intraosseous) access?
There was a recent summary of the current evidence published this month in Resuscitation.
Hat tip to the authors. Read these data for yourself as this is not medical advice.
It’s free for you to download.
Unfortunately, the optimal route is still not yet known.
It’s challenging to tease out the right answer as there have been no randomized controlled trials comparing IO to IV access in outside of hospital cardiac arrest.
We can subgroup it further and study if humeral is superior to tibial or vice versa.
Most trials have been observational.
Thankfully, there seem to be 5 RCT’s in the works to answer these questions.
My personal opinion is to obtain the fastest access one could obtain but I would love to hear directly from the boots on the ground as to what they think is best given the state of the data.
Should we give our cardiac arrest patients glucocorticoids?
Citation for Access in OHCA
Hooper A, Nolan JP, Rees N, Walker A, Perkins GD, Couper K. Drug routes in out-of-hospital cardiac arrest: A summary of current evidence. Resuscitation. 2022 Dec;181:70-78. doi: 10.1016/j.resuscitation.2022.10.015. Epub 2022 Oct 26. PMID: 36309248.
Link to Article
Link to FULL FREE PDF
How to Support My Work
Discover my book, “The Vasopressor & Inotrope Handbook: A Practical Guide for Healthcare Professionals,” a must-read for those in the field! You have several options to get your hands on a copy while supporting my endeavors. If you’re in the US, you can order directly from me with a special touch: a signed copy. Please note that I handle these shipments personally, so I appreciate your patience.
I recommend purchasing through THIS AMAZON LINK for quicker delivery or international orders. When you use this link, I earn an additional commission at no extra cost to you, which is a great way to support my work.
Stay tuned for the audiobook version, which will soon be available on Audible. It’s an exciting addition that I’m eager to share with you!
Disclosures
Although great care has been taken to ensure that the information in this post is accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
