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Cardiac arrest? A lifeline through the leg could save you

A new method of inserting an intraosseous catheter into the bone marrow in the leg will be adopted by paramedics from the Singapore Civil Defence Force from August, to help those suffering from cardiac arrest.   

SINGAPORE: From August, paramedics from the Singapore Civil Defence Force (SCDF) will adopt a new method to help those suffering from cardiac arrest, which involves drilling a hole into your leg.

The SCDF said on Friday (July 25) that this new method opens a pathway to the bone marrow in the leg. An intraosseous (IO) catheter is then inserted so that adrenaline to restore blood flow to the heart can be delivered straight into the blood stream.

With this method, the success rate of vascular access to the blood stream can be boosted to more than 90 per cent, compared to the 50 per cent using the traditional blood vessel method, said Dr Kenneth Tan, Associate Consultant at the Singapore General Hospital's (SGH) Department of Emergency Medicine. 

The current method, which requires searching for the right blood vessel in which to insert the needle, may also be hindered by flattened veins. Narrowed or blocked blood vessels of obese patients, or those with kidney failure, may also impede the delivery of the drug, Dr Tan said.

Half of SCDF's paramedic fleet will adopt the procedure from August, should they fail to locate a vein for traditional IV delivery. The other half will do so after six months, SCDF said. It added that its paramedics have received training on the method since September 2013.

Doctors at the Department of Emergency Medicine at Singapore General Hospital are working with the SCDF on this initiative. The hospital faces about 1,800 cases of cardiac arrest each year.

The method has been used primarily in a hospital setting, but this is the first time the procedure is being used in the field, according to the SCDF. Paramedics in countries such as Australia have also adopted the bone marrow procedure as their first approach to treating cardiac arrest patients in the field, and with great success, SGH said. 

While the bone marrow method is more expensive than the existing procedure, the SCDF said it will not pass on the additional cost to patients.

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