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No subject enrollment.
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This study will evaluate using intraosseous vascular access and intravenous vascular access to give pediatric patients the necessary medications to perform rapid sequence intubation, for patients with airway difficulties.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intraosseous (IO) drug delivery | patients in whom intraosseous (IO) vascular access has been established for rapid sequence intubation drug delivery. | ||
| Peripheral intravenous (IV) drug delivery | patients in whom peripheral intravenous (IV) vascular access has been established for rapid sequence intubation drug delivery. |
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| Measure | Description | Time Frame |
|---|---|---|
| Time from determination of need for vascular access for rapid sequence intubation to administration of first does of paralytic agent. | Time from determination of need for vascular access for rapid sequence intubation to administration of first does of paralytic agent. | during rapid sequence intubation procedure, average expected time frame 30 minutes |
| Time from vascular access to intubation first attempt, as indicated by the first attempt to visualize the larynx with the laryngoscope. | Time from vascular access to intubation first attempt, as indicated by the first attempt to visualize the larynx with the laryngoscope. | during rapid sequence intubation procedure, average expected time frame 30 minutes |
| time from vascular access to successful intubation | time from vascular access to successful intubation | during rapid sequence intubation procedure, average expected time frame 30 minutes |
| number of attempts necessary for successful intubation | number of attempts necessary for successful intubation | during rapid sequence intubation procedure, average expected time frame 30 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| Intubation difficulty | The Intubation Difficulty Scale is a validated tool used to grade the difficulty with which a patient was intubated for airway managment during rapid sequence intubation. | during rapid sequence intubation procedure, average time frame 30 minutes |
| operator satisfaction with intubating conditions |
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Inclusion Criteria:
Exclusion Criteria:
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patients in the emergency department with airway difficulties requiring rapid sequence intubation.
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| Name | Affiliation | Role |
|---|---|---|
| Edward Truemper, MD | University of Nebraska | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Omaha Children's Hospital and Medical Center | Omaha | Nebraska | 68198 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 21856044 | Background | Reades R, Studnek JR, Vandeventer S, Garrett J. Intraosseous versus intravenous vascular access during out-of-hospital cardiac arrest: a randomized controlled trial. Ann Emerg Med. 2011 Dec;58(6):509-16. doi: 10.1016/j.annemergmed.2011.07.020. | |
| 9416711 | Background | Adnet F, Borron SW, Racine SX, Clemessy JL, Fournier JL, Plaisance P, Lapandry C. The intubation difficulty scale (IDS): proposal and evaluation of a new score characterizing the complexity of endotracheal intubation. Anesthesiology. 1997 Dec;87(6):1290-7. doi: 10.1097/00000542-199712000-00005. |
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operator satisfaction with intubating conditions |
| during rapid sequence intubation procedure, average time frame 30 minutes |
| failure rate of endotracheal intubation | failure rate of endotracheal intubation and requirement for alternative airway management. | during rapid sequence intubation procedure, average time frame 30 minutes |
| Time from presentation of patient to vascular access established | Time from presentation of patient to vascular access established | during rapid sequence intubation procedure, average time frame 30 minutes |
| Determine the incidence of short term catheter related complications for each technique | Determine the incidence of short term catheter related complications for each technique | during emergency department stay, average time frame 24 hours |
| 21893125 | Background | Leidel BA, Kirchhoff C, Bogner V, Braunstein V, Biberthaler P, Kanz KG. Comparison of intraosseous versus central venous vascular access in adults under resuscitation in the emergency department with inaccessible peripheral veins. Resuscitation. 2012 Jan;83(1):40-5. doi: 10.1016/j.resuscitation.2011.08.017. Epub 2011 Sep 3. |
| 20956049 | Background | Deakin CD, Nolan JP, Soar J, Sunde K, Koster RW, Smith GB, Perkins GD. European Resuscitation Council Guidelines for Resuscitation 2010 Section 4. Adult advanced life support. Resuscitation. 2010 Oct;81(10):1305-52. doi: 10.1016/j.resuscitation.2010.08.017. No abstract available. |
| 20956258 | Background | Kleinman ME, de Caen AR, Chameides L, Atkins DL, Berg RA, Berg MD, Bhanji F, Biarent D, Bingham R, Coovadia AH, Hazinski MF, Hickey RW, Nadkarni VM, Reis AG, Rodriguez-Nunez A, Tibballs J, Zaritsky AL, Zideman D; Pediatric Basic and Advanced Life Support Chapter Collaborators. Part 10: Pediatric basic and advanced life support: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation. 2010 Oct 19;122(16 Suppl 2):S466-515. doi: 10.1161/CIRCULATIONAHA.110.971093. |
| 19325359 | Background | Brierley J, Carcillo JA, Choong K, Cornell T, Decaen A, Deymann A, Doctor A, Davis A, Duff J, Dugas MA, Duncan A, Evans B, Feldman J, Felmet K, Fisher G, Frankel L, Jeffries H, Greenwald B, Gutierrez J, Hall M, Han YY, Hanson J, Hazelzet J, Hernan L, Kiff J, Kissoon N, Kon A, Irazuzta J, Lin J, Lorts A, Mariscalco M, Mehta R, Nadel S, Nguyen T, Nicholson C, Peters M, Okhuysen-Cawley R, Poulton T, Relves M, Rodriguez A, Rozenfeld R, Schnitzler E, Shanley T, Kache S, Skippen P, Torres A, von Dessauer B, Weingarten J, Yeh T, Zaritsky A, Stojadinovic B, Zimmerman J, Zuckerberg A. Clinical practice parameters for hemodynamic support of pediatric and neonatal septic shock: 2007 update from the American College of Critical Care Medicine. Crit Care Med. 2009 Feb;37(2):666-88. doi: 10.1097/CCM.0b013e31819323c6. |
| 18082778 | Background | Von Hoff DD, Kuhn JG, Burris HA 3rd, Miller LJ. Does intraosseous equal intravenous? A pharmacokinetic study. Am J Emerg Med. 2008 Jan;26(1):31-8. doi: 10.1016/j.ajem.2007.03.024. |
| 1688484 | Background | Orlowski JP, Porembka DT, Gallagher JM, Lockrem JD, VanLente F. Comparison study of intraosseous, central intravenous, and peripheral intravenous infusions of emergency drugs. Am J Dis Child. 1990 Jan;144(1):112-7. doi: 10.1001/archpedi.1990.02150250124049. |
| 11099426 | Background | Laurin EG, Sakles JC, Panacek EA, Rantapaa AA, Redd J. A comparison of succinylcholine and rocuronium for rapid-sequence intubation of emergency department patients. Acad Emerg Med. 2000 Dec;7(12):1362-9. doi: 10.1111/j.1553-2712.2000.tb00493.x. |
| 18425883 | Background | Perry JJ, Lee JS, Sillberg VA, Wells GA. Rocuronium versus succinylcholine for rapid sequence induction intubation. Cochrane Database Syst Rev. 2008 Apr 16;(2):CD002788. doi: 10.1002/14651858.CD002788.pub2. |