Which intravascular access technique should we use for covid-19 patient resuscitation: a preliminary investigation

Obtaining vascular access is a key procedure in hemodynamically unstable patient conditions (1). This is particularly important for patients with cardiac arrest, where the American Heart Association (AHA) as well as the European Resuscitation Council (ERC) recommendations for non-shockable rhythms recommend that vascular access and adrenaline supply be provided as soon as possible (2, 3). Under CPR conditions, the vascular bed is collapsed, therefore numerous attempts at intravenous access may prolong the time to administer drugs and CPR fluids, as well as cause the rescuer to focus too much on one procedure, while under out-of-hospital CPR settings the number of members of the emergency team is limited and the need for chest compressions, as well as airway management and ventilation support, are important (4). Ready-to-use kits for performing intraosseous accesses, including NIO-Adult, which is an example of an automatic, spring-loaded, single-use intraosseous access device (fig. 1), may be helpful in this respect.