EZ-IO Drill

[paramedicmike]

never used any of the automated devices, just the plain old fashioned IOs. Just wondering is the flush from the gun any more painful than the regular IO?

You're not flushing from the drill. Once you place the IO, you remove the drill and connect your tubing the hub. The flush is done the same way as with the manually placed IOs. It's a slow, hand push of the fluid with a syringe.

I would imagine the discomfort is the same as the manually placed IOs. However, it used to be that IOs were used in kids as a last resort to IV access. Chances are, if you were going the IO route the kid was all but pronounced so patient discomfort wasn't really a major concern. With these devices (i.e. EZIO), in line with the new ACLS guidelines, IOs can be placed on just about anyone regardless of age. And the patient doesn't always have to be in a cardiac arrest situation to have one placed, either. As such, the concern for patient comfort or discomfort is much more important that in the past.

Does this help?

-be safe

[Rezq304]

My service put the EZ -IO drill on the trucks earlier this year. A great tool in my opinion. Has anyone else had any experience with these?

Yes, my service has been using the EZ-IO for about six months now. Numerous lines have been place. I've not had a bit of trouble out of it as of this date. The only situation I've seen the EZIO not work was on a mobidly obese patient & the cathater wasn't long enough to go through the flesh & the bone. Definitely think it's a much needed asset & serves as a good "last line" means of gaining IV access.

[Musicmedic5150]

We get them this month. We have been using the BIG in the past. Someone said earlier about the cost "not coming out of the individual providers pocket". I will have to disagree. If you are a tax base fuded system it eventually does come from your pocket.

[bigj1130]

I'm also going to add here. Is anyone using EZ I/o humeral head insertion? We started doing it the begining of this year. I haven't done one yet because if I personally am up by that part of the body I am going to go EJ. I was wondering if people have had issues with securing the catheter, moving patient etc.

[Ridryder 911]

I'm also going to add here. Is anyone using EZ I/o humeral head insertion? We started doing it the begining of this year. I haven't done one yet because if I personally am up by that part of the body I am going to go EJ. I was wondering if people have had issues with securing the catheter, moving patient etc.

Why would you not establish an EJ instead of a EZ I/O ? I/O should be used as an alternative if there is not an ability to establish an venous IV. As well, you do understand the "catheter" per say is in the bone and securing it should NOT be a problem and if there is; you have not performed the I/O properly.

R/r 911

[bigj1130]

Rid, Humeral Head I/O was a skill we introduced at the begining of the year as an alternative insertion site to tiberal tuberosity. I will say that in most cardiac arrests we have been running here in Austin that an I/O is primary insertion point on more than a few of those cardiac arrests. There was talk for about 2 months about our system removing EJ cannulation as a skill. This is where the humeral head insertion point came in. The paramedics in the system have convinced all of our powers that be to let us keep the skill by demonstrating proficiency knowledge of when's, why's, and how's etc. However we were still left with the Humeral head as an insertion point for our EZ-I/O. When i am asking about securing the I/O cath we all know that things can be bumped during movement etc. and I am curious how easy this site is to maintain and keep patent with everything else going on up by the chest head and neck area. One of the things I like about the tibial tuberosity is the insertion point. It is a skill easily erformed because it is out of the way of chest compressions, airway management, and defibrillation

[mshow00]

My questions here is simple, can one push all "IV meds" through an IO? More pointedly would you be able to push D50? I ask because we had a call out here last weekend where a morbidly obese diabetic went in to severe hypoglycemia. When the original unit arrived on scene, they immediately checked her sugar: 24, and called for an assist truck (my partner and I) Our supervisior also met us out there. All 5 of us (three medics and two basics) were looking for a vein to do an IV, but could not find sh*t. My partner found an EJ, but when he started to push the D50 it blew. We do not have IO's of any kind here (unless its a peds code) The first crew had already given Glucagon IM recheck of the BGL:19. My partner was finally (last second attempt) to obtain an IV in the left breast of the woman, and was given two Amps of D50 and transported. With her BGL being so low (and her unresponsive) and the Glucagon not helping we had no choice. The ED Doc told us to never ever do that again (IV to the breast) but good job as well. Would an IO option have made things easier?

disclaimer: we did not delay transport to obtain said iv, after ej blew the other basic and i cleared a path through the house to we could carry this woman out to our str.

[chbare]

Yes, IO access would have been a great asset in this situation. Yes, you can push IV medications to include dextrose 50%, colloids, and blood products through a patent IO site.

Take care,

chbare.

[Ridryder 911]

Rid, Humeral Head I/O was a skill we introduced at the begining of the year as an alternative insertion site to tiberal tuberosity. I will say that in most cardiac arrests we have been running here in Austin that an I/O is primary insertion point on more than a few of those cardiac arrests. There was talk for about 2 months about our system removing EJ cannulation as a skill. This is where the humeral head insertion point came in. The paramedics in the system have convinced all of our powers that be to let us keep the skill by demonstrating proficiency knowledge of when's, why's, and how's etc. However we were still left with the Humeral head as an insertion point for our EZ-I/O. When i am asking about securing the I/O cath we all know that things can be bumped during movement etc. and I am curious how easy this site is to maintain and keep patent with everything else going on up by the chest head and neck area. One of the things I like about the tibial tuberosity is the insertion point. It is a skill easily erformed because it is out of the way of chest compressions, airway management, and defibrillation

Wow! I thought Austin was smarter than that. Why would anyone even consider to remove a peripheral line access over an I/O route? Yes, they are wonderful but should never be thought as more than an alternative route. Yes, I have started my fair share too; but personally unless one has a pressure bag and large enough bore .. it is hard to still infuse at a decent rate. No matter what site is utilized. Again, peripheral (especially EJ) would be a much more preferred site not even thinking of the long term effects of I/O.

Sorry, misunderstood your comment on securing the I/O. That is about the only advantage FAST has that it does have a "dome" cover to help protect the site.

R/r 911

[fireflymedic]

EZ IO's are a great tool, but they are just that a tool among many others. I am preferable to the drills as opposed to the spring loaded. The sternal IO's just look evil, we've got 'em, but never placed one to my knowledge. However, I am with everybody else on infusing the lido - the drilling pain is rated about a two, but infusion about an 8 without lido so please use it, even if you think your patient is out. They're great if you absolutely can't get IV access. Only bad thing is the fracture issue, so a multi ortho trauma pt can be a pain and also the infusion rate without a pump or pressure bag is slow as all get out, but yeah, anything that can go IV can go IO.