Comparison of two intraosseous infusion systems for adult emergency medical use

Abstract

Introduction: The current guidelines of the European Resuscitation Council (ERC) stipulate that an intraosseous access should be placed if establishing a peripheral venous access for cardiopulmonary resuscitation (CPR) would involve delays. The aim of this study was therefore to compare a manual intraosseous infusion technique (MAN-IO) and a semi-automatic intraosseous infusion system (EZ-IO) using adult human cadavers as a model.

Materials and methods: After receiving verbal instruction and giving their written informed consent, the participants of the study were randomized into two groups (group I: MAN-IO, and group II: EZ-IO). In addition to the demographic data, the following were evaluated: (1) Number of attempts required to successfully place the infusion, (2) Insertion time, (3) Occurrence of technical complications and (4) User friendliness.

Results: Evaluation protocols from 84 study participants could be evaluated (MAN-IO: n=39 vs. EZ-IO: n=45). No significant differences were seen in the study participants' characteristics. Insertion times (MW+/-S.D.) of the respective successful attempts were comparable (MAN-IO: 33+/-28s vs. EZ-IO: 32+/-11s). When using the EZ-IO, the access was successfully established significantly more often on the first attempt (MAN-IO: 79.5% vs. EZ-IO: 97.8%; p<0.01). The EZ-IO was also found to have more advantages in terms of technical complications (MAN-IO: 15.4% vs. EZ-IO: 0.0%; p<0.01) and user friendliness (school grading system: MAN-IO: 1.9+/-0.7 vs. EZ-IO: 1.2+/-0.4; p<0.01).

Conclusions: In an adult human cadaver model, the semi-automatic system was proven to be more effective. The EZ-IO gave more successful results, was associated with fewer technical complications, and is user friendlier.