Notfälle im Rettungsdienst und in der Klinik: GefäΒzugänge bei Kindern

Abstract

Vascular access is necessary for the administration of medication and for the collection of blood samples in an emergency. Peripheral venous access is occasionally difficult in infants and younger children, particularly during emergencies. However, reliable vascular access and prompt treatment are required in these circumstances to successfully treat the patient. During the rescue service, immediate establishment of the intraosseous vascular access is very important, in case peripheral vascular access cannot be established rapidly. Although numerous transportable ultrasound machines have been developed, which may be utilized during rescue service, relatively difficult access hampers their application during the rescue service. After stabilizing vital functions and transportation to the hospital, peripheral venous access or central venous access can be attempted again in order to replace intraosseous vascular access. In this manuscript, we first discuss intraosseous vascular access as an alternative vascular access technique, which can be attempted during the rescue service. Next, we introduce ultrasound-guided and other techniques for peripheral and central vascular access as potential alternatives for pediatric patients with difficult vascular access or in-hospital emergency situations. Timely decision-making and prompt utilization of alternative procedures to achieve unimpeded vascular access is essential for the treatment and survival of pediatric patients in an emergency.