Intraosseous needle preference among emergency physicians

• Published in: Annals of emergency medicine 2004-10, Vol.44 (4), p.S67-S68
• Main Authors: Lera, L., Vasallo, A., Hsu, C.K.
• Format: Article
• Language: English
• ISSN: 0196-0644; 1097-6760
• DOI: 10.1016/j.annemergmed.2004.07.223

Study objectives: Anecdotally, choice of needle types used during intraosseous line placement among emergency physicians may be governed more by availability within the institution than by preference. We determine a preference of intraosseous line needles among physicians who are trained using 2 types of intraosseous line needles. Methods: This was a survey (anonymous) conducted over a 2-week period after participation in multiple bimonthly institutional animal care and utilization committee–approved procedure laboratories conducted over a 5-year period. Inclusion criteria were resident and attending physicians who had attended at least 1 laboratory. Participants were instructed on the placement of Jamshidi and Cook (threaded) needles by a lecture and by demonstration, followed by placement of both needle types into the extremities of live Yorkshire swine that were intubated, anesthetized, and maintained on inhaled isoflurane. Aspiration of bone marrow was the endpoint for successful placement. The survey was conducted by junior residents using a coded, standardized data collection tool outside of the laboratory setting at least 10 days after the most recent laboratory. Instructors of the laboratory did not participate in and were not present during data collection. Results: There were a total of 22 participants. Of these, 3 (13.6%) were attending physicians and 19 (86.3%) were residents. Participants attended a mean of 3.3 laboratories (range 1 to 12). Seventeen (77.2%) participants were comfortable in intraosseous line placement; 14 were comfortable with intraosseous line placement in humans (mean 0.63, range 0 to 4). Eighteen (81.8%) preferred Jamshidi, none (0%) preferred Cook, and 4 (18.2%) had no preference. Eighteen (81.8%) participants preferred Jamshidi because of ease of use, 9 (40.9%) because of successful placement, and 1 (4.5%) because of decreased complications. The number of laboratories attended or level of training did not reveal any particular trend. Conclusion: Emergency physicians preferred the Jamshidi-type needles over Cook. Limitations were the animal model and small numbers.