Use of the pediatric EZ-IO needle by emergency medical services providers

The aim of this study was to examine emergency medical services providers' use of a new intraosseous needle designed for pediatric patients.

This prospective pilot study was conducted between May 2006 and October 2007. After completing an initial training session, the EZ-IO PD was deployed for use on patients. Emergency medical services (EMS) providers completed a telephone data collection process after each insertion attempt. Data regarding insertion failure or success (insertion of needle into the bone with subsequent fluid flow), time to fluid flow, provider comfort with the device, device performance assessment, and recommendation for future use were collected.

Two hundred forty-six EMS providers (EMT-P and registered nurses) from 14 EMS agencies consented to participation. Nineteen insertions were completed by 19 different providers during the study period. Successful insertion was achieved in 18 (95%) of 19 patients (95% confidence interval [CI], 85%-100%). Successful insertion was achieved in less than 60 seconds by 13 (72%) of 15 providers (95% CI, 60%-94%; 4 providers, no response). Fourteen out of 17 providers (82%) reported feeling very comfortable (59%) or comfortable (23%) with the device (95% CI, 64%-100%; 2 non-responses). Fourteen (82%) of 17 providers (95% CI, 64%-100%) with a successful insertion felt that the device worked very well, and the remaining 3 (18%) felt that it worked well. Thirteen (78%) of 17 providers (95% CI, 56%-96%) recommended future use of the EZ-IO needle over the Illinois needle. Two providers (11%) recommended the use of both needles, and 2 providers (11%) were unsure if they would recommend one of the intraosseous needles over the other. A total of 5 complications were reported by the providers: infiltration during use (2); slow flow rate (2); and needle dislodgement (1) when moving the patient into the ambulance.

This device has a high insertion success rate with our provider group. Most of our EMS providers also felt comfortable using the device and recommend the device for future use.