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Hey Jon!  Congrats on your first post...  As far as IO, I've only had the opportunity to use them twice in 13 years, both trauma pts.  Our protocal here is that if you can't get a peripheral within 30 seconds to go IO on our criticals.  I have to admit that on the first one (10 years ago, all we had was the Jamashidi needle, a hand inserted pain in the butt) I tried 3 peripherals over a few minutes just because I hated those Jamashidi needles...  Compromised pt care??  Delayed fluids for a few minutes, but I don't think that would have saved his life...  My second experience was much better (approx 6 mos ago).  We now have the Easy IO (battery operated) drill which is much easier, quicker and more safe than those antiques.  I had that IO in in no time flat and flowing like crazy...  Unfortunately this pt did not make it either..  (I wonder if I should have a complex???  Don't think so....)

Anyway.  I love having the Easy IO in our bag o' tricks, it's a life saver.  We still have the antique for a backup, since the Easy IO is battery operated.

My success rate so far is 100% in the field.

Are you working as a Paramedic in New York?  What would it/did it take to get your P card here in the States?

At my service we have the EZ IO drills and they work great, as well as being easy (hence the name) to operate. Our protocol for the use of them is that we must attempt two periphrial lines before we discide to drill the pt....so we don't just use them on just anyone we can't get a line on...They are great for trauma when you really have to get that line but can't for whatever reason...and I have also used it on a couple of codes since I'm not a fan of meds down the tube...I love it, and the drill is so easy and quick to use. Since the land mark is the tibial tuberosity, thats also a pretty big space to fill up in there and I haven't had to use a pressure bag to infuse the fluid. As far as how often we use it...the answer would be not very often because most times you can get a line in...but when you can't get the line and you need one...they become well worth the money in my mind.

I will say that the sternal IO's I have never seen work very well at all... every time I have seen one done they didn't flow well and if they did you had to put on a pressure bag to get it to do so...then still had trouble. Not to mention they are harder to use.

If you dont have them, I say get the EZIO :)

jonmedic101 says ...

Dear medicchick4123,

i totally agree that introosseous can be so easy to use and a good way to get a vascular access. are you farmiliar with the B.I.G (Bone injection gun) ? the same penetration site but smaller, lighter, automatic and disposable?

I think you'll love it too. Me myself like both, but the Israeli EMS and Israeli army prefers the B.I.G and use exclusively that. i agrre with that since i tend to trust the B.I.G to operate at all times. if i need to use an intraosseous device on a pateint placed under wet conditions such as heavy rain ect., i would prefer something automatic that doesn't need to be operated by electricity.

Jon,

No I have not ever had the opportunity to use or see the gun but it does sound better. I will have to try and locate a rep that sells it so we can get a demo if the director will let us...It sounds better all the way around. What is your landmark for the gun? Still the tibial tuberosity, I know some of them you can use in the humeral head area...but we aren't allowed to access that site. Just curious.

I work in a little town in Kentucky called Lawrenceburg...

Yeah they wont let us access the humeral head with the drill, maybe it's easier or safer to do with the gun?  I'm on shift today and Im gonna look the gun up and show it to everybody...I know we won't be able to get it now because we just spent all kinds of money on switching over to the drill system. Maybe in the future though, that would be a better option for us to look at. It sounds like it would be.