Cochrane · systematic review · CD011386
Comparison of routes for achieving parenteral access with a focus on the management of patients with Ebola virus disease
Ker, K, Tansley, G, Beecher, D, et al. · Cochrane Database of Systematic Reviews · 2015 · Cochrane Library
InjuriesAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
15
current version
GRADE rated
10
No studies
5
Included studies
NR
No studies 5 · 33.3%Ungraded 0 · 0%Very low 0 · 0%Low 6 · 40%Moderate 4 · 26.7%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Intravenous versus intraosseous route for achieving parenteral access
Population: adults or children requiring fluid delivered by a parenteral route (one study testing insertion and the volume of fluid delivered in manikins by practitioners wearing protective equipment was also included)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Insertion failures Intravenous vs intraosseous route | RR 3.89 [2.39, 6.33] | 2 studies · 242 participants | Low Downgraded: risk of bias |
Time to infusion/placement Intravenous vs intraosseous route | no estimate extracted | 4 studies · 342 participants | Moderate Downgraded: risk of bias |
Dislodgement of device during infusion Intravenous vs intraosseous route | RR 0.53 [0.18, 1.55] | 1 study · 182 participants | Low Downgraded: risk of bias |
Needlestick injuries Intravenous vs intraosseous route | no estimate extracted | NR | No studies |
Volume of fluid infused Intravenous vs intraosseous route | no estimate extracted | 1 study · 182 participants | Moderate Downgraded: risk of bias |
Intravenous versus subcutaneous route for achieving parenteral access
Population: adults or children requiring parenteral access for infusion of fluids or medication
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Insertion failures Intravenous vs subcutaneous route | RR 14.79 [2.87, 76.08] | 3 studies · 238 participants | Moderate Downgraded: risk of bias, imprecision |
Time to infusion/placement Intravenous vs subcutaneous route | no estimate extracted | 1 study · 96 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Dislodgement of device Intravenous vs subcutaneous route | RR 3.78 [1.16, 12.34] | 1 study · 67 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Needlestick injuries Intravenous vs subcutaneous route | no estimate extracted | NR | No studies |
Volume of fluid infused Intravenous vs subcutaneous route | no estimate extracted | 4 studies · 4 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Saphenous vein cutdown versus intraosseous route for achieving parenteral access
Population: trainee paramedics using both methods of gaining parenteral access on cadavers
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Insertion failures Saphenous vein cutdown vs intraosseous route | RR 4 [0.51, 31.13] | 1 study · 13 participants | Low Downgraded: risk of bias |
Time to infusion/placement Saphenous vein cutdown vs intraosseous route | no estimate extracted | 1 study · 13 participants | Moderate Downgraded: risk of bias |
Dislodgement of device Saphenous vein cutdown vs intraosseous route | no estimate extracted | NR | No studies |
Needlestick injuries Saphenous vein cutdown vs intraosseous route | no estimate extracted | NR | No studies |
Volume of fluid inserted Saphenous vein cutdown vs intraosseous route | no estimate extracted | NR | No studies |