Emerg Med J 30:423-424 doi:10.1136/emermed-2013-202602.1
  • Best Evidence Topic Reports

BET 1: Local anaesthetics in intraosseous access

Report by: Michael Stewart, St5 Emergency Medicine

Search checked by: Shelley Regan, St5 Emergency Medicine

Institution: Blackpool Victoria Hospital, Blackpool, UK


A short-cut review was carried out to establish whether flushing an intraosseous needle with local anaesthetic or saline is more effective at reducing the pain injecting drugs or fluid via this route. Two studies were relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are shown in table 1. The clinical bottom line is that injecting lidocaine both before and after flushing an intraosseous needle is …

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Among patients with minor TBI (GCS 13-15) getting CT scans ≥ 24 hours after injury, what proportion have a traumatic finding?


0.5% - 43% response rate
3% - 41% response rate
10% - 16% response rate

Related original article: PCT head imaging in patients with head injury who present after 24 h of injury: a retrospective cohort study

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