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Consecutive field trials using two different intraosseous devices.

Ralph J Frascone¹, Joe P Jensen, Kory Kaye

¹Regions Hospital Emergency Medical Services, Regions Hospital, St. Paul, MN 55101, USA.

Prehospital Emergency Care

|April 25, 2007

Summary

The EZ-IO device demonstrated a higher success rate for intraosseous (IO) access compared to the F.A.S.T.1 system in prehospital settings. Further randomized trials are needed to confirm these findings on IO device performance.

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Area of Science:

Emergency Medicine
Trauma Care
Medical Device Evaluation

Background:

Establishing intravenous (IV) access can be challenging in adult trauma and medical patients.
Intraosseous (IO) access offers an alternative route for fluid and medication delivery when IV access is difficult.
Two FDA-approved IO devices, F.A.S.T.1 and EZ-IO, are available for prehospital use.

Purpose of the Study:

To compare the performance of the F.A.S.T.1 and EZ-IO intraosseous devices in prehospital settings.
To evaluate provider success rates, comfort, and satisfaction with each IO device.
To identify potential differences in device efficacy and ease of use by emergency medical providers.

Main Methods:

Two sequential field trials were conducted involving prehospital providers.

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Trial 1 evaluated the F.A.S.T.1 system with 124 participating providers.

Trial 2 evaluated the EZ-IO system with 389 participating providers, collecting data on insertion success, comfort, and satisfaction.

Main Results:

The EZ-IO achieved a significantly higher success rate (87%) compared to the F.A.S.T.1 (72%) (p = 0.009).
Providers using the EZ-IO attempted fewer prior IV insertions (2.0) than those using F.A.S.T.1 (2.6) (p = 0.005).
No significant differences were found in provider comfort or assessed device performance between the two devices.

Conclusions:

The EZ-IO device demonstrated superior insertion success rates compared to the F.A.S.T.1 in this prehospital study.
Limitations include non-randomization, sequential trial design, potential learning effects, and self-reported data.
A prospective, randomized evaluation is recommended to definitively assess provider insertion success rates for these IO devices.