European experts standardize newborn access to save lives
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A team of medical professionals from eleven European countries developed new recommendations to help doctors quickly establish vascular access in newborn babies during emergencies.
Led by Bernhard Schwaberger of the Medical University of Graz and Anna Milan of Guy’s and St Thomas’ NHS Foundation Trust, the Neonatal European Vascular Access Team created a guide for inserting intraosseous devices, needles drilled into bone marrow, when traditional vein access is impossible.
The group addressed a gap in care, as using intraosseous access has been slower to catch on in newborns compared to adults, due to concerns about the fragility of infant bones. They reviewed existing data on anatomy and devices to create a practical, unified guide. Without quick access for drugs and fluids, newborn resuscitation efforts, including those outlined in upcoming European and American guidelines, cannot succeed.
The recommendations emphasize precise anatomical knowledge, noting that the tibia, a lower leg bone, isn’t always the safest insertion site, particularly for premature babies. The team advises considering the femur or humerus instead, depending on the infant’s gestational age and health. They also suggest hospitals standardize on a few types of intraosseous devices and thoroughly train staff in their use. The guide also details safe insertion techniques, pain management, and monitoring to prevent complications like infection or limb damage.
Finally, the experts call for further research, particularly on premature infants, to improve the practice.
