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Prehospital peripheral intravenous vascular access success rates in children

机译：儿童院前外周静脉通路的成功率

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Objective. Achieving successful peripheral intravenous (PIV) vascular access in children can be difficult. In the prehospital setting, opportunities are rare. Obtaining access becomes vital in emergent and life-threating conditions, such as seizures, hypoglycemia, and cardiac arrest. This study examines prehospital pediatric PIV attempts, success rates, and the impact of patient age. Methods. This was a retrospective chart review of patients aged 18 years or younger receiving prehospital PIV attempts from January 1, 2003, through May 31, 2011. Included cases were identified by querying electronic patient care reports for PIV attempts within the specified age range. The documentation of PIV attempts and successes was reported by emergency medical service providers. This study was approved by an institutional review board. Results. Throughout the 101-month study period, there were 261,008 ambulance responses. PIV attempts were made in 4188 patients aged 18 years or younger. PIV placement was successful in 3699 patients (88.3%) and failed in 489 (11.7%). Age was significantly associated with success. Each 1-year increase in age was associated with an 11% increase in odds of PIV success (odds ratio, 1.11; 95% CI, 1.09-1.12; p < 0.001). Success was lowest in patients younger than 2 years old, with an overall success rate of 64.1% (141/220). Accounting for multiple attempts, success was achieved in 53.0% of attempts (141/266). Conclusions. Prehospital PIV attempts are uncommon (2% of emergent responses). Success rates are significantly associated with patient age in the pediatric population and lowest in those aged 2 years or less. Consideration of alternative forms of vascular access in this population may be beneficial.
机译：目的。在儿童中获得成功的外周静脉（PIV）血管通路可能很困难。在院前环境中，机会很少。在急诊和危及生命的情况下（例如癫痫发作，低血糖和心脏骤停），获得治疗至关重要。这项研究检查了院前儿科PIV的尝试，成功率以及患者年龄的影响。方法。这是一项回顾性图表回顾，回顾了从2003年1月1日至2011年5月31日接受院前PIV尝试的18岁以下患者。通过查询电子患者护理报告中指定年龄范围内的PIV尝试，确定了包括病例。紧急医疗服务提供者报告了PIV尝试和成功的记录。该研究得到机构审查委员会的批准。结果。在整个101个月的研究期内，有261,008辆救护车得到了回应。对4188名18岁以下的患者进行了PIV尝试。 PIV放置成功3699例（88.3％），失败489例（11.7％）。年龄与成功显着相关。年龄每增加1年，PIV成功几率就会增加11％（赔率，1.11; 95％CI，1.09-1.12; p <0.001）。 2岁以下患者的成功率最低，总体成功率为64.1％（141/220）。考虑到多次尝试，成功率为53.0％（141/266）。结论。院前PIV尝试很少见（占紧急反应的2％）。成功率与儿科患者的年龄显着相关，而在2岁以下的患者中成功率最低。考虑该人群中血管通路的其他形式可能是有益的。

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