Alternative ways to introduce resuscitation at the prehospital stage in emergency conditions


Keywords: intraosseous access, intravenous access, emergency conditions, prehospital medical care.

Abstract

Annotation. Objectivecarrying out a comparative assessment of the advantages and disadvantages of intravenous (IV) and intraosseous (IO) resuscitation, which are used by emergency and emergency teams in the Vinnytsia region. The work used statistical data of the Vinnytsia Regional Center for Emergency Medical Care and Disaster Medicine for the period 2019-2021, carry through content analysis of domestic and foreign scientific sources, applied biblio-semantic, analytical, and statistical methods for studying the use of intraosseous and intravenous methods in emergency cases. According to the Vinnytsia Regional Center for Emergency Medical Care and Disaster Medicine for the three years 2019-2021. we observe a low percentage of use of intraosseous access 0,2% - 0,1%, respectively. In the event of an accident in the patient's condition “without changes” a total of 786 injections were carried out both intravenously and intraosseously. In 2019, out of the total number, non-infusion therapy was performed in 71,0% of male patients and 11,1% of female patients, and 11,2% intraosseously only in male patients. Compared to 2020, only 0,3% intraosseously (2 female patients) and in 2021, no intraosseous resuscitation was performed at all. In a state of “deterioration” during an accident (road accident, etc.) for 2019, 87,5% of men and 12,5% of women were injected with drugs intravenously; for 2020, 50% for both males and 50% for females were infused intravenously; for 2021, 87,5% of men and 12,5% of women underwent intravenous resuscitation, intraosseous resuscitation was never performed, provided that the condition of patients worsened. And “death in the presence” occurred during resuscitation for 2019 88,8% (of which 77,7% for men and 11,1% for women) by intravenous access and 11.2 VC (males); for 2020 88,9% intravenously (of which 72,2% for men and 16,7% for women) and 11,1% intraosseously (of which 1 male and 1 female article); in 2021, 65,0% of intravenous access was performed for men and 25,0% for women, while no patient received intraosseous access. In case of a sudden illness, the percentage of intraosseous resuscitation in the state of “deterioration” was as follows: for the period 2019-2021. no intraosseous access was performed. In the state of “death in the presence” for 2019, intraosseous infusion was 3,4%; 2020 – 3,8%; 2021 – 1,9%. Thus, the intraosseous method has several undeniable advantages compared to the intravenous one, but in Ukraine, it is little used in the practice of mobile emergency medical teams with a syringe gun (connector – BLG), both considering the age characteristics: for adults (blue) and children (red color) and prescribed in the fundamental algorithms of clinical/modern protocols for the treatment of circulatory arrest due to insufficient practical and theoretical skills of medical personnel of emergency teams. The analysis of the use of intraosseous methods in emergency medical care gave impetus to conducting theoretical and practical classes for future doctors to master skills and reduce prehospital and early hospital mortality in patients with complement fixation reactions.

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Published
2022-03-28
How to Cite
Chorna, V. V., Matviichuk, M. V., Podolyan, V. M., Gumeniuk, N. I., & Khliestova, I. V. (2022). Alternative ways to introduce resuscitation at the prehospital stage in emergency conditions. Reports of Vinnytsia National Medical University, 26(1), 125-129. https://doi.org/https://doi.org/10.31393/reports-vnmedical-2022-26(1)-23
Section
SOCIAL MEDICINE, ORGANIZATION OF HEALTH PROTECTION

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