Intraosseous vascular access in adults using the EZ-IO in an emergency department

Abstract

Background: Intraosseous (IO) access is an alternative to conventional intravenous access.

Aims: We evaluate the use of the EZ-IO as an alternative vascular access for patients in the emergency department.

Methods: A non-randomized, prospective, observational study was performed in adults using the EZ-IO powered drill device.

Results: Twenty-four patients were recruited. There were 35 intraosseous insertions, including 24 tibial and 11 humeral insertions. All EZ-IO insertions were achieved within 20 s and were successful at the first attempt except for one. Of the intraosseous insertions, 88.6% were reported to be easier than intravenous cannulation. We found flow rates to be significantly faster using a pressure bag. The seniority of operators did not affect the success of insertion. Complications included a glove being caught in the drill device and extravasation of fluid although they were easily preventable.

Conclusion: The use of the EZ-IO provides a fast, easy and reliable alternative mode of venous access, especially in the resuscitation of patients with no venous vascular access in the emergency department. Flow rates may be improved by the use of pressure bags.

Keywords: Infusion rates; Intraosseous needle; Intravenous access.