Assuntos
Humanos , Masculino , Feminino , Monitorização Transcutânea dos Gases Sanguíneos/instrumentação , Monitorização Transcutânea dos Gases Sanguíneos/métodos , Monitorização Transcutânea dos Gases Sanguíneos , Administração Cutânea , Estimulação Elétrica Nervosa Transcutânea/instrumentação , Estimulação Elétrica Nervosa Transcutânea/métodos , Anestesia/estatística & dados numéricos , Anestesia/tendências , Anestesia , Monitorização Transcutânea dos Gases Sanguíneos/estatística & dados numéricos , Monitorização Transcutânea dos Gases Sanguíneos/normas , Monitorização Transcutânea dos Gases Sanguíneos/tendênciasAssuntos
Monitorização Transcutânea dos Gases Sanguíneos , Lesões Encefálicas/sangue , Hipóxia Encefálica/diagnóstico , Medicina Militar/métodos , Monitorização Fisiológica/métodos , Lesões Relacionadas à Guerra/sangue , Adulto , Campanha Afegã de 2001- , Viagem Aérea , Traumatismos por Explosões , Monitorização Transcutânea dos Gases Sanguíneos/instrumentação , Serviços Médicos de Emergência , Humanos , Hipóxia Encefálica/sangue , Masculino , Militares , Monitorização Fisiológica/instrumentação , Transporte de PacientesRESUMO
OBJECTIVES: To describe the Spanish military medical staff's experience with the use of intraosseous lines for fluid therapy in a combat zone. PATIENTS AND METHODS: Descriptive study of 25 patients (30 needles). The patients were injured by firearms or explosive devices, or had multiple injuries, and were attended by Spanish military physicians in western Afghanistan (Herat) between March 2007 and June 2008. RESULTS: The bone puncture was performed on 19 patients in prehospital settings. The remaining 6 patients underwent the procedure in the Spanish military hospital. All patients were men; the mean (SD) age was 26 (2.3) years. Most belonged to the Afghan National Army (64%) and had injuries caused by explosive devices (68%). The largest percentage of injuries involved the lower limbs (56%). A line could be inserted in 76% of the cases (100% at the military hospital). The first-choice site of puncture was the anterior tibial tuberosity. Fluids and medications were successfully administered through the intraosseous lines. No complications occurred during needle insertion, but 5 patients reported pain. CONCLUSION: Our experience suggests that intraosseous access can provide an alternative to venous access for treating trauma patients in combat zones.
Assuntos
Osso e Ossos , Hidratação/métodos , Militares , Guerra , Ferimentos e Lesões/terapia , Adulto , Afeganistão , Humanos , Estudos Longitudinais , Masculino , Punções , EspanhaRESUMO
Objetivos: Se expone la experiencia de de la Sanidad Militar española en el uso de dispositivos de punción intraósea para fluidoterapia en una zona de combate. Pacientes y método: Estudio descriptivo de una serie de 25 pacientes. El número de agujas empleadas fue de 30. Los sujetos de estudio fueron aquellos pacientes con lesión por de arma de fuego, por explosión de artefactos explosivos o politraumatizados, atendidos por médicos militares españoles en la región oeste de Afganistán (Herat) entre marzo de 2007 y Junio de 2008. Resultados: La técnica se realizó en 19 pacientes en medio prehospitalario. A los 6 restantes les fue realizada la técnica en el hospital militar español (ROLE 2). Todos los pacientes eran varones, con una media de edad de 26 años (DE 2,3), la mayoría pertenecían al Ejército Nacional afgano (64%), presentaron heridas por artefacto explosivo (68%) y el lugar de lesión predominante fueron los miembros inferiores (56%). Se consiguió una vía permeable en el 76% de los casos. En el ROLE 2 la técnica obtuvo éxito en el 100% de los casos. El primer lugar de elección elegido fue la tuberosidad tibial anterior. La vía intraósea fue empleada para la perfusión de fluidos y medicamentos. No se encontraron complicaciones secundarias a la inserción de la aguja. Sin embargo, 5 pacientes presentaron dolor. Conclusión: Basándose en nuestra experiencia, el empleo del acceso intraóseo como alternativa al venoso, puede ser recomendable para el tratamiento del paciente traumático atendido en el ámbito militar (AU)
Objectives: To describe the Spanish military medical staffs experience with the use of intraosseous lines for fluid therapy in a combat zone. Patients and methods: Descriptive study of 25 patients (30 needles). The patients were injured by firearms or explosive devices, or had multiple injuries, and were attended by Spanish military physicians in western Afghanistan (Herat) between March 2007 and June 2008. Results: The bone puncture was performed on 19 patients in prehospital settings. The remaining 6 patients underwent the procedure in the Spanish military hospital. All patients were men; the mean (SD) age was 26 (2.3) years. Most belonged to the Afghan National Army (64%) and had injuries caused by explosive devices (68%). The largest percentage of injuries involved the lower limbs (56%). A line could be inserted in 76% of the cases (100% at the military hospital). The first-choice site of puncture was the anterior tibial tuberosity. Fluids and medications were successfully administered through the intraosseous lines. No complications occurred during needle insertion, but 5 patients reported pain. Conclusion: Our experience suggests that intraosseous access can provide an alternative to venous access for treating trauma patients in combat zones (AU)
