[Demystifying the intraosseous infusion technique]. / Tous les secrets de l'accès vasculaire intra-osseux.

Intraosseous infusion provides a safe and effective access to the vascular system that allows for administration of urgent therapies in both adults and children. It has few contraindications and complications are rare. The needle is most commonly inserted in the proximal tibia or anterior humerus. Different devices are available but those with a traditional drill are the most widespread. The intraosseous infusion procedure is easy and the learning curve is short, making it the best alternative when traditional intravenous access is not possible or delayed.

Le cathétérisme intra-osseux permet un accès vasculaire rapide, facile, sûr et efficace pour l'administration de thérapeutiques urgentes, chez l'enfant comme chez l'adulte. Il présente peu de contre-indications et ses complications sont rares. Les sites d'implantation privilégiés sont les abords tibial proximal et huméral chez l'adulte. Différents systèmes de cathétérisme sont disponibles ; les plus répandus et probablement les plus simples d'utilisation sont maintenant motorisés. La technique d'utilisation de ces cathéters est facilement acquise après une courte formation. Ils représentent la première alternative à l'accès veineux périphérique dans la gestion des urgences vitales lorsque celui-ci n'est pas disponible.

Opiophobia in Emergency Department Healthcare Providers: A Survey in Western Switzerland.

Opiophobia contributes to oligoanalgesia in the emergency department (ED), but its definition varies, and its association to healthcare providers' personality traits has been scantly explored. Our purpose was to study the different definitions of opiophobia and their association with two personality traits of doctors and nurses working in EDs, namely the stress from uncertainty and risk-taking. We used three online questionnaires: the 'Attitude Towards Morphine Use' Score (ATMS), the Stress From Uncertainty Scale (SUS) and the Risk-Taking Scale (RTS). Doctors and nurses from nine hospital EDs in francophone Switzerland were invited to participate. The ATMS score was analyzed according to demographic characteristics, SUS, and RTS. The response rate was 56%, with 57% of respondents being nurses and 63% women. Doctors, less experienced and non-indigenous participants had a significantly higher ATMS (all p ≤ 0.01). The main contributors of the ATMS were the fear of side effects and of addiction. In multivariate analysis, being a doctor, less experience and non-indigenous status were predictive of the ATMS; each point of the SUS increased the ATMS by 0.24 point. The fear of side effects and of addiction were the major contributors of opiophobia among ED healthcare providers; opiophobia was also associated with their personality traits.