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{
    "pk": 14250,
    "title": "Sternal Intraosseous Devices: Review of the Literature",
    "subtitle": null,
    "abstract": "Introduction:\n The intraosseous (IO) route is one of the primary means of vascular access in critically ill and injured patients. The most common sites used are the proximal humerus, proximal tibia, and sternum. Sternal IO placement remains an often-overlooked option in emergency and prehospital medicine. Due to the conflicts in Afghanistan and Iraq the use of sternal IOs have increased.\nMethods: \nThe authors conducted a limited review, searching PubMed and Google Scholar databases for “sternal IO,” “sternal intraosseous,” and “intraosseous” without specific date limitations. A total of 47 articles were included in this review.\nResults:\n Sternal IOs are currently FDA approved for ages 12 and older. Sternal IO access offers several anatomical, pharmacokinetic, hemodynamic, and logistical advantages over peripheral intravenous and other IO points of access. Sternal IO use carries many of the same risks and limitations as the humeral and tibial sites. Sternal IO gravity flow rates are sufficient for transfusing blood and resuscitation. In addition, studies demonstrated they are safe during active CPR.\nConclusion:\n The sternal IO route remains underutilized in civilian settings. When considering IO vascular access in adults or older children, medical providers should consider the sternum as the recommended IO access, particularly if the user is a novice with IO devices, increased flow rates are required, the patient has extremity trauma, or administration of a lipid soluble drug is anticipated.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "Intraosseous"
        },
        {
            "word": "resuscitation"
        },
        {
            "word": "Trauma"
        },
        {
            "word": "Sternum"
        },
        {
            "word": "intravenous"
        }
    ],
    "section": "Critical Care",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/9x34k0kq",
    "frozenauthors": [
        {
            "first_name": "Jared",
            "middle_name": "A.",
            "last_name": "Laney",
            "name_suffix": "",
            "institution": "Texas A&M University College of Medicine, Bryan, Texas",
            "department": "None"
        },
        {
            "first_name": "Jonathan",
            "middle_name": "",
            "last_name": "Friedman",
            "name_suffix": "",
            "institution": "Washington County Ambulance District, Mineral Point, Missouri",
            "department": "None"
        },
        {
            "first_name": "Andrew",
            "middle_name": "D.",
            "last_name": "Fisher",
            "name_suffix": "",
            "institution": "Medical Command, Texas Army National Guard, Austin, Texas\nUniversity of New Mexico School of Medicine, Department of Surgery, Albuquerque, New Mexico",
            "department": "None"
        }
    ],
    "date_submitted": "2020-07-02T09:25:19+05:30",
    "date_accepted": "2020-07-02T09:25:19+05:30",
    "date_published": "2021-03-24T23:12:22+05:30",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/14250/galley/7348/download/"
        }
    ]
}