INTRAOSSEOUS ACCESS IN THE PRE-HOSPITAL SETTING: EXPERIENCES AND OPINIONS OF HEALTHCARE PROFESSIONALS

Yıl 2025, Cilt: 10 Sayı: 3, 327 - 345, 28.12.2025

Nurten Tosun

https://doi.org/10.54409/hod.1738693

Öz

ABSTRACT
Objective: This study investigates the current state of intraosseous procedures performed by healthcare professionals in pre-hospital emergency medical services. It explores the factors involved, the challenges encountered, and the recommendations from these professionals.
Materials and Methods: A cross-sectional, descriptive, and mixed-methods approach was employed. Data were collected from 403 healthcare professionals (emergency medical technicians, paramedics, and doctors) working in pre-hospital emergency healthcare services across Turkey from November to December 2024 via an online survey. Quantitative data were analysed using frequency and percentage distributions, along with the chi-square test. Qualitative data were assessed through content analysis.
Results: Only 19.9% of participants had previously performed an intraosseous procedure. Among those who had, the majority preferred intraosseous access, particularly in cases of cardiac arrest and when vascular access was unavailable. The most commonly used insertion site was the proximal tibia. Manual needles were less favoured compared to automatic devices such as BIG and EZ-IO. The use of intraosseous access was associated with factors such as gender, education level, years of experience, previous training in intraosseous procedures, and access to equipment. The main challenges identified through qualitative data included equipment shortages, lack of training and experience, technical difficulties, and patient- and environment-related factors. Participants recommended expanding training programmes, improving equipment access, and enhancing technical application and practice.
Conclusions: A comprehensive strategy that incorporates a multifaceted training approach, improved equipment access, and enhanced technical procedures is necessary to facilitate the wider and safer implementation of intraosseous access.

Anahtar Kelimeler

Intraosseous Access , Pre-hospital , Enegergency , Experiences , Healthcare Professionals

Etik Beyan

The study was approved by Istinye University Human Research Ethics Committee (Decision number and date: 24-233/ November 22, 2024). The study was conducted in accordance with the Declaration of Helsinki.

Destekleyen Kurum

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Teşekkür

I would like to thank the health professionals who participated in this study

Hastane Öncesi Ortamda İntraosseöz Girişim: Sağlık Profesyonellerinin Deneyimleri ve Görüşleri

Öz

Amaç: Bu çalışma, hastane öncesi acil tıbbi hizmetlerde sağlık profesyonelleri tarafından gerçekleştirilen intraosseöz prosedürlerin mevcut durumunu araştırmaktadır. İlgili faktörleri, karşılaşılan zorlukları ve bu profesyonellerin önerilerini incelemektedir.
Gereç ve Yöntemler: Kesitsel, tanımlayıcı ve karma yöntemler kullanılmıştır. Veriler, Kasım-Aralık 2024 tarihleri arasında Türkiye genelinde hastane öncesi acil sağlık hizmetlerinde çalışan 403 sağlık profesyonelinden (acil tıp teknisyenleri, paramedikler ve doktorlar) çevrimiçi anket yoluyla toplanmıştır. Nicel veriler, sıklık ve yüzde dağılımları ile ki-kare testi kullanılarak analiz edilmiştir. Nitel veriler ise içerik analizi ile değerlendirilmiştir.
Bulgular: Katılımcıların sadece %19,9'u daha önce intraosseöz girişim uygulamıştı. Uygulama yapmış olanların çoğu, özellikle kalp durması ve vasküler erişim mümkün olmadığında intraosseöz girişimi tercih etmişti. En sık kullanılan giriş yeri proksimal tibia idi. Manuel iğneler, BIG ve EZ-IO gibi otomatik cihazlara kıyasla daha az tercih edildi. intraosseöz girişimin kullanımı, cinsiyet, eğitim düzeyi, deneyim yılı, intraosseöz prosedürleri konusunda önceki eğitim ve ekipmana erişim gibi faktörlerle ilişkiliydi. Nitel verilerle belirlenen başlıca zorluklar arasında ekipman eksikliği, eğitim ve deneyim eksikliği, teknik zorluklar ve hasta ve çevreyle ilgili faktörler yer aldı. Katılımcılar, eğitim programlarının genişletilmesini, ekipmana erişimin iyileştirilmesini ve teknik uygulama ve pratiğin geliştirilmesini önerdi.
Sonuç: İntraosseöz girişimin daha geniş ve daha güvenli bir şekilde uygulanmasını kolaylaştırmak için çok yönlü bir eğitim yaklaşımı, ekipman erişiminin iyileştirilmesi ve teknik prosedürlerin geliştirilmesini içeren kapsamlı bir strateji gereklidir

Anahtar Kelimeler

İntraosseöz girişim , Hastane Öncesi , Acil Durum , Deneyimler , Sağlık profesyonelleri

Kaynakça

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