Efficacy and safety of the EZ-IO™ intraosseous device: Out-of-hospital implementation of a management algorithm for difficult vascular access

Gazin, N.; Auger, H.; Jabre, P.; Jaulin, C.; Lecarpentier, Éric; Bertrand, Catherine; Margenet, A.; Combes, X.

doi:10.1016/j.resuscitation.2010.09.008

Cited by 76 publications

(64 citation statements)

References 12 publications

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“…The overall success rate of IOA procedures in our analysis was 98.8%. These results are comparable with several other previously published investigations ( [4]: 87%, [2]: 96%, [7]: 97%). Moreover, the 1 st attempt success rate in our investigation with 94% is in line with other data concern- [5]: 32 seconds compared with manual Cook needles).…”

Section: Discussionsupporting

confidence: 93%

“…In line with the results of a French ground based EMS study with 39 IOA in 9876 patients (0.39%) [7] and a German air based EMS study with an increase from 0.1% to 0.4 % over four years [8], the IOA rate in our ground based EMS was 0.34%. A recently published report from Berlin, Germany, with a generous indication position for IOA showed an unexpectedly high overall IOA rate of 1.49% [9].…”

Section: Discussionsupporting

confidence: 88%

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Four years of EZ-IO® system in the preand in-hospital emergency setting

et al. 2013

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 88%

Four years of EZ-IO® system in the preand in-hospital emergency setting

et al. 2013

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“…It allows rapid placement with minimal chance of misplacement; it also has a low-profile intravenous adapter. [445][446][447][448][449][450] Familiarity with the use of these emergency techniques can be gained by keeping current with resuscitation courses, such as PALS and advanced pediatric life support.…”

Section: Adjuncts To Airway Management and Resuscitationmentioning

confidence: 99%

Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures: Update 2016

Coté¹,

Wilson²

2016

Pediatrics

251

199

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The safe sedation of children for procedures requires a systematic approach that includes the following: no administration of sedating medication without the safety net of medical/dental supervision, careful presedation evaluation for underlying medical or surgical conditions that would place the child at increased risk from sedating medications, appropriate fasting for elective procedures and a balance between the depth of sedation and risk for those who are unable to fast because of the urgent nature of the procedure, a focused airway examination for large (kissing) tonsils or anatomic airway abnormalities that might increase the potential for airway obstruction, a clear understanding of the medication's pharmacokinetic and pharmacodynamic effects and drug interactions, appropriate training and skills in airway management to allow rescue of the patient, age-and size-appropriate equipment for airway management and venous access, appropriate medications and reversal agents, suffi cient numbers of staff to both carry out the procedure and monitor the patient, appropriate physiologic monitoring during and after the procedure, a properly equipped and staffed recovery area, recovery to the presedation level of consciousness before discharge from medical/dental supervision, and appropriate discharge instructions. This report was developed through a collaborative effort of the

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“…with the BIG device) and successful first attempt (EZ-IO: 90%, BIG: 80%) [4]. Other studies report similar success rates (96%, 96.5%, 97%) with the EZ-IO [5,9,12]. Success rates of central venous canulation and IO access were compared in 10 trauma patients on whom peripheral vascular access could not be achieved after three attempts for a maximum of two minutes; first attempt success rate was 90% for IO access and 60% for central venous access.…”

Section: Discussionmentioning

confidence: 92%

“…In lifethreatening cases such as major trauma, cardiopulmonary arrest, sepsis, shock, and major burns, IO infusion is recommended by both the International Liaison Committee on Resuscitation (ILCOR) and the American Heart Association (AHA) guidelines [7,8]. IO access is considered a safe, fast, effective alternative route of fluid and drug administration [5,[7][8][9]. Although its clinical use began after the Tocantis' rabbit experiments in 1941, interest was lost after the development of improved IV equipment and methods.…”

Section: Introductionmentioning

confidence: 99%

The Efficacy of Intraosseous Blood and Ringer Lactate in a Rabbit Model of Hemorrhagic Hypovolemia

Korkmaz¹

2013

CMR

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Purpose: In this study, flow rates of intraosseously (IO) or intravenously (IV) administered fluids (blood orRinger lactate) and their effects on vital signs were examined in a rabbit model of hypovolemia. Methods: Underanesthesia, 20 mL of blood was removed from each of the 36 New Zealand-type rabbits. Ten minutes later, each group of nine rabbits received one of four fluids by gravity flow from a height of 100 cm: blood via IO, Ringer Laktat (RL) via IO, blood via IV, or RL via IV. IO fluids were given in the proximal tibia through a 15 g needle placed with an EZ-IO instrument; IV fluids were given through a 22g catheter in the femoral vein. Vital signs were monitored for four hours after the infusion ended. Results: Flow rates were blood IO 2.6 mL/min, RL IO 3.4 mL/min, blood IV 3.2 mL/min, and RL IV 11.8 mL/min. Ten minutes after fluid administration ended, in the RL via IO group, heart rate was significantly slower than preinfusion; in the blood via IO group, body temperature was significantly lower than preinfusion, and in the blood via IO group, StO2 saturation was higher than preinfusion. Postinfusion respiratory rates within groups were not significantly different than preinfusion rates. Vital sign changes between groups were not significantly different. Conclusion: Fluids given by gravity feed through an IO needle were effective in treating hypovolemia in this rabbit model, but the flow of RL and blood were significantly slower through the 15g IO needle than the 22g IV catheter.

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Efficacy and safety of the EZ-IO™ intraosseous device: Out-of-hospital implementation of a management algorithm for difficult vascular access

Cited by 76 publications

References 12 publications

Four years of EZ-IO® system in the preand in-hospital emergency setting

Four years of EZ-IO® system in the preand in-hospital emergency setting

Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures: Update 2016

The Efficacy of Intraosseous Blood and Ringer Lactate in a Rabbit Model of Hemorrhagic Hypovolemia

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