Consecutive Field Trials Using Two Different Intraosseous Devices

Abstract

Objective. Establishing traditional intravenous (IV) access in adult trauma andmedical patients can be difficult. We evaluated provider performance for obtaining intraosseous access with two FDA-approved intraosseous devices (F.A.S.T. 1^TM andEZ-IO®) in two sequential field trials. Methods. One hundred twenty-four providers consented to participate in the first field trial evaluating the use of the F.A.S.T. 1^TM system. Three hundred eighty-nine providers consented to participate in the second field trial, evaluating the use of the EZ-IO. Following each insertion attempt, a telephone data collection process with a member of the research team was completed. Insertion success rate andmeasures of provider comfort andsatisfaction with each device were collected andanalyzed. Results. One hundred seventy-eight insertions (89 F.A.S.T. 1^TM; 89 EZ-IO®) were completed between February 2000 andDecember 2005. Sixty-four of the 89 insertions of the F.A.S.T. 1^TM were successful, and78 of the 89 insertions of the EZ-IO® were successful (72% vs. 87%; χ² = 6.8; p = 0.009). Providers using the F.A.S.T.1^TM attempted more IV insertions prior to using the IO device than the providers using the EZ-IO (2.6 vs. 2.0, p = 0.005). There were no differences in provider comfort or provider assessed device performance between the two devices (p = 0.52; p = 0.13, respectively). Conclusion. In our comparison of two field trials of prehospital provider use of the F.A.S.T.1^TM andEZ-IO® systems, more successful insertions with the EZ-IO® were achieved than with the F.A.S.T.1^TM device. Limitations of our comparison include nonrandomization, the sequential field trial design, the potential for a learning effect, andself-reporting of data points by providers. A prospective, randomized evaluation of these devices is warranted to draw definitive conclusions about provider insertion success rate with these devices.

Key words::

• intraosseous
• IO
• IV access
• fluid infusion
• intravenous failure
• emergency medical services
• emergency medicine