EZ IO

[AASIAirMed]

I have been using the EZ-IO for several moths now, and it has never failed me. I have not been convinced that it is the same as IV adminstration, but it sure as hell beats putting the meds down the tube

[ffpm41]

We use the FAST IO with mixed results and have started looking at teh EZ IO. I'd say that the problem with the FAST has been it getting displaced during aggressive CPR (from what I've been told, not what I've seen).

I know Portland and Multnomah County in Oregon have been using the EZ io and love it.

[MARKW]

Just had our inservice for the EZIO a few weeks ago. Coming soon to all depts. in Alameda County Ca. Tried the Autopulse awhile back and it worked great. Our medical director has advised that there are some problems with it and we will not be using in the near future.

[herseyjh]

Which IO device to use? This is a good question, and when I had to address this question for my service I was excited in the prospect of getting some up to date kit; however, after reviewing studies I was surprised to find out that none of these new devices have research to show that they are better than any other device.

I even found one study that showed a good old fashioned spinal needle had a better success rate. I say go with the cheapest and smallest device out there as they all seem to do the same thing. Mind you some sound and look cooler than others.

[Ridryder 911]

...Which IO device to use? This is a good question, and when I had to address this question for my service I was excited in the prospect of getting some up to date kit; however, after reviewing studies I was surprised to find out that none of these new devices have research to show that they are better than any other device.

I even found one study that showed a good old fashioned spinal needle had a better success rate. I say go with the cheapest and smallest device out there as they all seem to do the same thing. Mind you some sound and look cooler than others. quote]

Ever try to place a spinal needle into an adults tibia or humerus?... I didn't think so.. Even when performing LP's I have had them bend. Spinal needles are way to flimsy to try to induce thorough an adult periosteum.. maybe on an infant or child. I have them bend on ped.'s, For a few bucks, better to do it right the first time..... Far as studies have shown that I/O are just as fast as venous access.. hence the reason to change from ETT.

R/r 911

[herseyjh]

Perhaps you should take your issues up with the author of the study and not the person who is reporting it. Spinal needles aside, I am sure, if you review the studies out there you will find very little difference between products, therefore why not go with the most economical and compact models?

Of course, I hate to be the master of the obvious here, but as you pointed out spinal needles suck to place as an adult IO. Then how did they manage to do so well in theses studies? All I am saying is before throwing out you old IO stuff and run off to get these new ‘high-speed’ IO systems sit down and think about what you are spending your money on. If the answer is ‘for something new that costs more but does not have any clinical benefit’ you answer should be not to bother.

[Ridryder 911]

Sorry, did not mean to come across on you. I too have read the studies as well. Very true not much difference in performance, but again this was used in a controlled environmental setting. When reading studies, one needs to also consider the setting, the parameters, and subjects

One could compare paddles versus external defib pads in the same manner, there is no significantly clinical difference, rather than the ease to use, and the safety of the product. yet, I have not used paddles over 15 years, because of the same reasons.

What my main point is the needle was not designed to be used as a I/O. the outside only has a cap and the needle itself is very flimsy. Hazards such as bending, accidental needle sticks, etc..this would costs far more than the marketed products. Spinal needles is approx $40 for 20, which you cannot purchase separately, as well you will need different sizes. I have used FAST, EZ I/O, Jamshidi, and yes even spinal needles in the field & ER settings, my anecdotal experience will tell you it is much easier to perform an adult I/O in the 90 second limit, with tools that are designed to do it fast and easy.

Yes, we need to be concerned of the cost but as well as use of practicality. If the product is difficult is hard to use, cumbersome, no one will use it.. then what have you saved? This is now the standard of care and no longer the use of ET med.'s are recommended. I know that some I/O kit's are now selling the needles separate and EZ I/O now has ped.'s as well as adult needle sizes, so all could be carried together.

R/r 911

[herseyjh]

Cost is always a difficult issue to bring up in health care, and for our service we made a compromise based on a few factors. The first being cost, as I mentioned, and the second was on the actual need for an IO system as we tend to place very few of them in a year, and the final factor was familiarity with equipment. We decided to stay on board with what our hospital is using and what the community based nursing stations have.

I will be honest, until I looked at these studies I was all for a new system, first seeing them in the military and then their use (the FAST 1) with an urban EMS system, but as I placed a few I began to wonder if we could manage with a old-fashioned IO needles. So far this has worked, but as you pointed out, studies can not completely emulate the field environment, and maybe as adult IO placements become more common place the need to switch to one of these devices will become evident.

[Ridryder 911]

I am sure that the cost will initially rise since the standards has changed as well, but maybe with some competition, they eventually go down.

R/r 911