It Is Known Since 1922 at 2B Level of Evidence, Yet Not Used: Attitude Towards Intraosseous Medication

OBJECTIVES: Intraosseous (IO) cannulation has a centuries-old history and is included in current adult resuscitation recommendations at the 2B evidence level, but abroad the technique has been reported to be underused. No survey has been conducted in Hungary yet, hence we aim to explore the possibility of adapting attitudinal methods that have been proven elsewhere.

METHODS: Data collected with a multi-platform, non-random, online questionnaire between 25 September and 29 October 2022. Our sample consisted of Hungarian students, their teachers and health professionals (n=168). Data were analysed by calculating χ² test, Kruskal-Wallis test and logistic regression in Jamovi 2.3.24.

RESULTS: 61.9% of the respondents (n=104) knew the indication for an IO device, while 153 respondents experienced a lack of IO cannulation despite existing evidence. Non-intraosseous attitudes were associated with 86 cases where the care manager chose a different preferred method. No significant difference was found between knowledge level of those who performed simulated IO cancellation only and those who also performed it in a live situation (post-hoc p=0.125), but there was a difference in all other group pairs (p<0.004). Among the predictors of willingness to participate in skills training, lack of intention to continue (MT 0.15-0.75) and previous simulation training (MT 1.26-34.8) were the most determining.

CONCLUSIONS: According to studies, attitude towards IO cannulation and theoretical knowledge level correlate. The difference in knowledge levels measured in our research could not be confirmed in any pair of groups but one. This suggests that there is a need to increase the number of IO skill trainings in Hungary, which is also demanded by the providers as well. This need can be met, and the quality of patient care will be improved by adapting a cost-effective foreign example, the ’tea trolley’ (26690648 PMID), avoiding the forgetting of a rarely used skill.