EZ-IO in pre-hospital care

February 28, 2011 by  
Filed under All Updates, EMS, Resus

French pre-hospital physicians liked the EZ-IO intraosseous drill, using it for drugs (including rapid sequence intubation drugs) and fluids in the pre-hospital setting. There was a very high insertion success rate.

OBJECTIVE: Intraosseous access is a rapid and safe alternative when peripheral vascular access is difficult. Our aim was to assess the safety and efficacy of a semi-automatic intraosseous infusion device (EZ-IO) when using a management algorithm for difficult vascular access in an out-of-hospital setting.

METHODS: This was a one-year prospective, observational study by mobile intensive care units. After staff training in the use of the EZ-IO device and provision of a management algorithm for difficult vascular access, all vehicles were equipped with the device. We determined device success rate and ease of use, resuscitation fluid volume and drugs administered by the intraosseous route, and complications at insertion site.

RESULTS: A total of 4666 patients required vascular access. The EZ-IO device was used in 30 cardiac arrest patients (25 adults; 5 children) and 9 adults with spontaneous cardiac activity. The success rate for first insertion was 84%. Overall success rate (max. 2 attempts) was 97%. The device was used for fluid resuscitation in 16 patients (mean volume: 680ml), adrenaline administration in 24 patients, and rapid sequence induction in 2 patients. There was only one local complication (transient local inflammation).

CONCLUSIONS: On implementation of an algorithm for the management of difficult vascular access, the EZ-IO device proved safe and highly effective in both adult and paediatric patients in an out-of-hospital emergency setting. It is a suitable device for consideration as a first-line option for difficult vascular access in this setting.
Efficacy and safety of the EZ-IOTM intraosseous device: Out-of-hospital implementation of a management algorithm for difficult vascular access
Resuscitation. 2011 Jan;82(1):126-9

Comments

2 Responses to “EZ-IO in pre-hospital care”

  1. Dr. J on March 1st, 2011 00:12

    My own practice is that the IO is THE initial vascular access device for the critically ill patient, adult or peds. IT is simple and safe, more importantly I can have it functioning in about 15 seconds which is a fraction of the time needed for an IV or a central line.
    If you arrive in arrest or extremis in my shop, and need immediate treatment with intravascular medications, your getting an IO. 15 minutes later when I have whatever definitive access I want, and the initial phase of resus is complete out it comes.
    Dr. J

  2. The LITFL Review 008 - Life in the FastLane on March 4th, 2011 01:01

    […] some decent research is coming out on the effectiveness of the EZ-IO for use in the pre-hospital setting, the difficult access patient, and resuscitating the critically unwell patient. Hopefully with […]