Intraosseous access in prehospital emergency care

Villena Esteo O

Objective: To assess the effectiveness of the EZ-IO device for intraosseous catheter

insertion in the prehospital emergency setting in terms of time needed to insert the

catheter into the bone marrow and the presence and number of complications.

Methods: Prospective observational study of patients treated between January 2008 and

December 2010 in the metropolitan area of Barcelona, Spain. We included patients with

hemodynamic instability or in cardiorespiratory arrest in whom venous access could not

be achieved within 90 minutes or after 3 attempts. Patients with good venous access or

who were not in critical condition were excluded. In all cases the intraosseous puncture

was performed with the EZ-IO in the tibia or the humerus.

Results: Forty-nine patients were included. More than half (67.3%) were male; ages

ranged from 4 months to 86 years (mean [SD] 49.29 [25.89] years). Most patients

were in cardiorespiratory arrest (77.6%). The bone marrow could be accessed within

10 minutes in 44.9% of the patients and few complications occurred during

insertion.

Conclusion: Rapid vascular access and a low complication rate make EZ-IO placement of

an intraosseous catheter an excellent for choice for injecting drugs or fluids when

patients are in cardiorespiratory arrest or other critical conditions in the prehospital

setting.

Villena Esteo O