Efficacy of the EZ-IO？ needle driver for out-of-hospital intraosseous access - a preliminary, observational, multicenter study

During a 24-month period, all cases of prehospital IO access using the EZ-IO？ needle driver within three operational areas of emergency medical services were prospectively recorded by a standardized questionnaire that needed to be filled out by the rescuer immediately after the mission and sent to the primary investigator. We determined the rate of successful insertion of the IO needle, the time required, immediate procedure-related complications, the level of previous experience with IO access, and operator's subjective satisfaction with the device.77 IO needle insertions were performed in 69 adults and five infants and children by emergency physicians (n = 72 applications) and paramedics (n = 5 applications). Needle placement was successful at the first attempt in all but 2 adults (one patient with unrecognized total knee arthroplasty, one case of needle obstruction after placement). The majority of users (92%) were relative novices with less than five previous IO needle placements. Of 22 responsive patients, 18 reported pain upon fluid administration via the needle. The rescuers' subjective rating regarding handling of the device and ease of needle insertion, as described by means of an analogue scale (0 = entirely unsatisfied, 10 = most satisfied), provided a median score of 10 (range 1-10).The EZ-IO？ needle driver was an efficient alternative to establish immediate out-of-hospital vascular access. However, significant pain upon intramedullary infusion was observed in the majority of responsive patients.Establishing immediate vascular access is a crucial step in the treatment of critically ill patients. Therefore, patients with difficult venous access remain a challenge for paramedics and emergency physicians. Using standard peripheral intravenous (IV) catheters often requires multiple attempts, is time consuming and may be ultimately unsuccessful. Unfavorable co-factors, such as hypovolemia, difficult access to the patient or poor lighting, can further aggravat