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A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
Published on: November 9, 2016
Comparison of two intraosseous infusion systems for adult emergency medical use
Thorsten Brenner1, Michael Bernhard, Matthias Helm
1Department of Anaesthesiology and Emergency Medicine, University of Heidelberg, D-69120 Heidelberg, Germany.
Insights
The semi-automatic EZ-IO system demonstrated superior effectiveness compared to the manual intraosseous infusion (MAN-IO) technique for establishing emergency vascular access. EZ-IO achieved higher first-attempt success rates and reduced complications in cadaver models.
Area of Science:
- Emergency Medicine
- Resuscitation Science
- Medical Device Technology
Background:
- European Resuscitation Council guidelines recommend intraosseous (IO) access when peripheral venous access is delayed during cardiopulmonary resuscitation (CPR).
- Comparing manual IO (MAN-IO) and semi-automatic IO (EZ-IO) systems is crucial for optimizing emergency procedures.
Purpose of the Study:
- To compare the efficacy and user-friendliness of MAN-IO versus the EZ-IO system.
- To evaluate insertion success rates, time, technical complications, and overall usability in an adult human cadaver model.
Main Methods:
- Randomized study involving 84 participants using adult human cadavers.
- Participants were assigned to either MAN-IO or EZ-IO groups.
- Evaluated parameters included number of attempts, insertion time, technical complications, and user friendliness.
Main Results:
- The EZ-IO system achieved significantly higher first-attempt success rates (97.8%) compared to MAN-IO (79.5%).
- The EZ-IO group experienced zero technical complications, whereas the MAN-IO group had 15.4% complications.
- User friendliness scores favored the EZ-IO system (1.2) over MAN-IO (1.9).
Conclusions:
- The semi-automatic EZ-IO system is more effective than the manual MAN-IO technique in a cadaver model.
- EZ-IO offers improved success rates, fewer technical complications, and enhanced user friendliness for intraosseous access.
- Findings support the use of semi-automatic devices for faster and safer intraosseous access in critical care settings.
Introduction:
The current guidelines of the European Resuscitation Council (ERC) stipulate that an intraosseous access should be placed if establishing a peripheral venous access for cardiopulmonary resuscitation (CPR) would involve delays. The aim of this study was therefore to compare a manual intraosseous infusion technique (MAN-IO) and a semi-automatic intraosseous infusion system (EZ-IO) using adult human cadavers as a model.
Materials And Methods:
After receiving verbal instruction and giving their written informed consent, the participants of the study were randomized into two groups (group I: MAN-IO, and group II: EZ-IO). In addition to the demographic data, the following were evaluated: (1) Number of attempts required to successfully place the infusion, (2) Insertion time, (3) Occurrence of technical complications and (4) User friendliness.
Results:
Evaluation protocols from 84 study participants could be evaluated (MAN-IO: n=39 vs. EZ-IO: n=45). No significant differences were seen in the study participants' characteristics. Insertion times (MW+/-S.D.) of the respective successful attempts were comparable (MAN-IO: 33+/-28s vs. EZ-IO: 32+/-11s). When using the EZ-IO, the access was successfully established significantly more often on the first attempt (MAN-IO: 79.5% vs. EZ-IO: 97.8%; p<0.01). The EZ-IO was also found to have more advantages in terms of technical complications (MAN-IO: 15.4% vs. EZ-IO: 0.0%; p<0.01) and user friendliness (school grading system: MAN-IO: 1.9+/-0.7 vs. EZ-IO: 1.2+/-0.4; p<0.01).
Conclusions:
In an adult human cadaver model, the semi-automatic system was proven to be more effective. The EZ-IO gave more successful results, was associated with fewer technical complications, and is user friendlier.
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