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Intraosseous access in prehospital emergency care

Villena Esteo O

Sistema de Emergencias Médicas de Cataluña. Barcelona, Spain.

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
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

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