EZ-IO

[bigj1130]

I personally have used the Ez-Io in a few situations. Respiratory arrest Cardiac arrest. These were used after more than 4 IV attempts. I personally do not think they are all they are cracked up to be(no pun intended) When i went through my inservice it was explained to me that all drugs would have the desired effects when given IO as IV. I find it hard to believe that a drug like adenosine as an example works just as fast IO as IV especially when it is beaten into your head in school most proximal vein to the heart etc. for adenosine admin. I did however find a study conducted by Ohio university that statesthat adenosine given in a dose of 0.17 mg/kg is just as effective IO on lab rats as IV . google IO adenosine if interested. Personally I think the drill is a last resort tool when nothing is working and in my opinion is cetainly a better med route than ET in cardiac arrest.

[hertzvanrental]

In the U.K where I work ( South East Coast Ambulance ) we have them on every truck and that's a lot of trucks.In fact we are the only service in the U.K to have this device.These are an excellent piece of kit especially in the seriously ill kid for example menningococcal septacaemia where me may need to give benzyl penicillin and glucose etc. It has been used many times to good effect and not just in an arrest. One of the Docs from our local E.D came out and asked one of our paramedics to come in and insert an EZ-IO as they were really struggling for a line in an O.D patient.

[thbarnes]

A previous service I worked for had them, but I never got the opportunity to use them. My present service is getting them in October. The hold up? There's no check box in the billing system for them. See "Private Service Thread".

[Riblett]

In my experience the IOs have been helpful in the fact that we were able to get an IV established through which to push our code drugs. But I have never had ROSC on a patient that it was used on. Not because it caused harm, but usually the patient had been arrested for a while and was far into circulatory collapse, making a periphral IV nearly impossible. Combined with the fact that it is much harder to push drugs through and delivery is ineffective.

[akflightmedic]

In my experience the IOs have been helpful in the fact that we were able to get an IV established through which to push our code drugs. But I have never had ROSC on a patient that it was used on. Not because it caused harm, but usually the patient had been arrested for a while and was far into circulatory collapse, making a periphral IV nearly impossible. Combined with the fact that it is much harder to push drugs through and delivery is ineffective.

Well first of all, IO is not an IV. It is intraosseuous acess into the vascular system, not intravenous. Therefore, using an EZIO is not establishing an IV but rather an IO.

Second, with statements such as the last one in your paragraph, it leads me to believe you have very limited experience and knowledge about the device.

It is very easy to push drugs thru, easier than your typical peripheal IV access. That is one of its benefits.

The other benefit of IO access is the drug is within the vascular system in seconds. Do some research.

If it has an "ineffective route of delivery" why would we even waste time. I mean if something is not going to work, a drug is never going to reach the system anyways, then why bother? This surely must be the biggest joke on EMS thus far if what you say is true....

[Dustdevil]

Seriously.

You could fight a structure fire with the flow rates we see through IOs out here.

Where are you plugging these things, the phalanges?

[Riblett]

In response to the comment that I should 'do my research,' I have. I have used the device in the field several times and personally found out how difficult it was to give fluids and push rapid push drugs. Of course the articles from the manufacturers and the studies are going to say that it works just great and is just like and IV. If you can get past the majority of those articles you will find plenty of field personnel who will tell you that yes it is an easy insertion, but delivery is significantly slower.

I have used the EZ IO four times on a code, pushing multiple drugs and a bolus through it on each. No I would not call that a lot, but it is more than a lot of providers. The first time I did it was much more difficult to push the drugs than with an IV and the bolus was a slow process. I thought that maybe my partner did not have it in the right place, but was assured that marrow had been aspirated and it was normal to meet significantly more resistance. Three more times I had the same experience. Maybe what I should have said is that makes it sometimes ineffective if you can't get the drugs in at the appropriate time.

And by the way, some of you should spend half as much time posting helpful information rather than degrading people for their posts (questions or answers) for any reason you would think of.

[Doczilla]

Riblett, personal experience with the device does not constitute "doing your research".

'zilla

[flight-lp]

I too have never had an issue infusing fluids or medications and have had ROSC's and have even induced hypothermia through an I/O. Were you using a pressure infusion bag? That may help you some..........................

[Riblett]

No, we did not have a pressure infusion bag. I thought about using a BP cuff, and probably will next time.