Delayed surgical care increases mortality and worsens neurologic outcomes in patients
with an Epidural Hematoma (EDH) that are deteriorating and showing signs of herniation
or coma [
1
,
2
,
3
,
4
]. This procedure and the equipment used are rarely encountered in the Emergency Department
(ED) and may not be as familiar to the Emergency Medicine Physician as the EZ-IO™
(EZ-IO™, Teleflex) drill they commonly use to obtain intraosseous (IO) access. There
now have been two case reports describing the use of the EZ-IO™ drill in lieu of the
traditional Emergency Burr hole procedure in patients with an EDH who are rapidly
deteriorating and emergency surgery is unavailable. Bulstrode et al. in 2017 published
a case report of a patient with an EDH where a neurosurgeon utilized the EZ-IO™ drill
to drain an occipital site EDH [
[5]
]. Then in 2018, Durnford et al. described the second case using an EZ-IO™ drill to
drain a rapidly expanding EDH, this time in a rural hospital by an Emergency Medicine
Physician with neurosurgeon guidance over the telephone [
[6]
]. Outside of these two case reports there is little evidence defining this novel
procedure.Keywords
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References
- Prognosis and clinical relevance of anisocoria-craniotomy latency for epidural hematoma in comatose patients.J Trauma Acute Care Surg. 1996; 41: 120-122
- Prognosis of epidural hematoma: is emergency burr hole trephination in craniocerebral trauma still justified today?.Unfallchirurg. 1993; 96: 682
- Prognosis after acute subdural or epidural haemorrhage.Acta Neurochir. 1988; 90: 111-116
- Comparison of management outcome of primary and secondary referred patients with traumatic extradural haematoma in a neurosurgical unit.Injury. 1991; 22: 323-325
- Temporising extradural haematoma by craniostomy using an intraosseous needle.Injury. 2017; 48: 1098-1100
- Temporising an extradural haematoma by intraosseous needle craniostomy in the District General Hospital by non-neurosurgical doctors - a case report.Journal of the Intensive Care Society. 2018; 19: 76-79
- Burr holes. Emergency medicine procedures.2nd ed. McGraw-Hill Professional, 2013: 761-767
Article Info
Publication History
Published online: May 07, 2020
Accepted:
May 4,
2020
Received in revised form:
April 20,
2020
Received:
February 15,
2020
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
