I have recently found that establishing an IO is so much faster than an IV in a code setting. You are not in the way of compressions in tight places. It flows great and it does not get tangled up with all of the other wires and tubes.
In system I work in we have an autopulse which does compressions but requires us to sit the pt up, cut the shirt and secure the autopulse to the LBB. During this there is no one at the leg of the pt so an IO is a faster option. The IV pole on the strectcher is down by the feet and the IV tubing stays out of the way of everything else. In the past year we started using EZ-IO and it is a small drill with a (lack of a better explanation) self tapping 15g neddle. It is very fast and keeps people from sticking a traditional IO through and through a tib of an infant or a peds pt.
I agree with you. But in maryland, we are required to try twice for peripheral IV access prior to EZ-IO usage. But in Virginia where I work full time we are going to be able to use it when we feel that peripheral IV access would be to hard. I like the EZ-IO and it is as the name says very EZ if you do it correctly.
Unless there is painfully obvious access, we go straight to the EZ-IO. It is faster and no looking for sites. I even used on a lady having a stroke. We tend to go on about 85% elderly calls. They have poor veins normally. Why waste the time. We also have three medics on scene.
Wow three medics! We usually have one on-scence intially and within 3-5 minutes a second one. With only having one medic, I tell the EMT to get the LMA and I do the IO and it is very fast. Our rescues have Autopulses that work sometimes but when they do it is like having another person.
It is the same in my system. It is all about documentation. We just had a code last shift and I had run on the pt before for hypoglycemia. It took a 24g in his hand to get the IV for D50. I knew he was a difficult stick and I would not be helping him to try for the 2 IVs first so I went for the IO and documented 2 IV attempts I made in my mind.
Tell me more about your statement Autoulses that work "sometimes". We field tested autopulse a year ago, had a few good saves and some failures of the unit, and I mean failure of the unit. Zoll was back the other day pushing the hard again, telling us they have not heard of any problems from anyone else. We just put the EZ-IO on our units, have not used it yet.
Thanks for that autopulse update and you IO comments. In our area we see our share of large patients and elderly. We run fly cars normally staffed with 2 medics, but at times you end up alone if working an extra truck so I hear what your saying.