Intraosseous vascular access is safe, effective and costs less than central venous catheters for patients in the hospital setting

Michael Dolister, Stephen Miller, Stephen Borron, Edward J Truemper, Manoj Shah, Muriel R. Lanford, Thomas E. Philbeck

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Purpose: Central venous catheters (CVCs) are often placed to resuscitate unstable emergency department (ED) patients. In an observational study, we assessed intraosseous (IO) vascular access in the hospital, and compared results to published experiences with CVC placement. Methods: Patients who would typically receive a CVC were considered for the study. Vascular access was gained using a powered IO device. Data collection included placement success, placement time, ease-of-use, satisfaction with flow rates, complications and subsequent CVC placement. Results: A total of 105 cases were studied from six centers. Mean age was 48.0±28.0 years and 53% were men; 85% of the patients were medical cases, and 53% were in cardiac/respiratory arrest. Of those, 48% returned to spontaneous circulation. A total of 94% of placements were successful on the first attempt. Mean time to IO access was 103.6±96.2 seconds. There was one serious complication - a lower extremity compartment syndrome. IO access costs $100/patient. Conclusions: The data revealed faster and more successful IO catheter placement than reported for CVCs, few complications and high user satisfaction. For simple placements, cost savings for IO access vs. CVCs was $195/procedure. If 20% of the 3.5 million CVCs placed annually were replaced with IO catheters, cost savings could approach $650 million/year. We conclude that IO access in place of CVCs delivers high value in terms of being a safe, fast and effective mode of vascular access for patients in the hospital setting, with potentially substantial cost savings. These data indicate that IO access is a cost effective and viable alternative to problematic CVC lines.

Original languageEnglish (US)
Pages (from-to)216-224
Number of pages9
JournalJournal of Vascular Access
Volume14
Issue number3
DOIs
StatePublished - Jul 1 2013

Fingerprint

Central Venous Catheters
Blood Vessels
Costs and Cost Analysis
Cost Savings
Catheters
Compartment Syndromes
Heart Arrest
Observational Studies
Hospital Emergency Service
Lower Extremity
Equipment and Supplies

Keywords

  • Central venous catheter
  • IO access
  • Intraosseous vascular access

ASJC Scopus subject areas

  • Surgery
  • Nephrology

Cite this

Dolister, M., Miller, S., Borron, S., Truemper, E. J., Shah, M., Lanford, M. R., & Philbeck, T. E. (2013). Intraosseous vascular access is safe, effective and costs less than central venous catheters for patients in the hospital setting. Journal of Vascular Access, 14(3), 216-224. https://doi.org/10.5301/jva.5000130

Intraosseous vascular access is safe, effective and costs less than central venous catheters for patients in the hospital setting. / Dolister, Michael; Miller, Stephen; Borron, Stephen; Truemper, Edward J; Shah, Manoj; Lanford, Muriel R.; Philbeck, Thomas E.

In: Journal of Vascular Access, Vol. 14, No. 3, 01.07.2013, p. 216-224.

Research output: Contribution to journalArticle

Dolister, Michael ; Miller, Stephen ; Borron, Stephen ; Truemper, Edward J ; Shah, Manoj ; Lanford, Muriel R. ; Philbeck, Thomas E. / Intraosseous vascular access is safe, effective and costs less than central venous catheters for patients in the hospital setting. In: Journal of Vascular Access. 2013 ; Vol. 14, No. 3. pp. 216-224.
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