Implementation of intraosseous infusion technique by aeromedical transport programs

Area of Science:

• Emergency Medicine
• Trauma Care
• Critical Care Transport

Background:

• Intraosseous infusion (IOI) offers a rapid alternative for vascular access when peripheral lines fail.
• Aeromedical transport programs play a crucial role in delivering critical care.
• Assessing the current adoption and barriers to IOI implementation in these programs is essential.

Purpose of the Study:

• To determine the extent of intraosseous infusion (IOI) utilization within aeromedical transport programs.
• To identify factors influencing the adoption or non-adoption of IOI.
• To evaluate the perceived efficacy and safety of IOI in prehospital critical care.

Main Methods:

• A telephone survey was conducted with 133 aeromedical transport programs.
• Data collected included current IOI usage, previous experience, training status, and perceived barriers.
• Specific questions addressed personnel authorized for IOI insertion and preferences for vascular access techniques.

Main Results:

• A significant majority (69.2%) of programs had never used or considered IOI.
• Only 13.5% had prior experience, and 15.8% were trained but not yet implementing.
• Successful insertion rates were approximately 80%, with few minor complications reported.

Conclusions:

• Intraosseous infusion (IOI) is a safe and effective technique that is currently underutilized in aeromedical transport.
• Barriers to implementation appear to be low, with many programs favoring IOI over traditional methods in challenging scenarios.
• Further consideration and broader implementation of IOI are warranted to improve emergency vascular access in critical care transport.