Department of Emergency Health Sciences, University of Texas Health Science Center San Antonio, San Antonio TX 78229, USA
San Antonio Fire Department, San Antonio, TX 78205, USA
Correspondence
Corresponding author. Department of Emergency Health Sciences, University of Texas Health Science Center San Antonio, San Antonio, TX 78229, USA. Tel.: +1 210 567 7598, +1 210 567 7887.
Department of Emergency Health Sciences, University of Texas Health Science Center San Antonio, San Antonio TX 78229, USA
San Antonio Fire Department, San Antonio, TX 78205, USA
Correspondence
Corresponding author. Department of Emergency Health Sciences, University of Texas Health Science Center San Antonio, San Antonio, TX 78229, USA. Tel.: +1 210 567 7598, +1 210 567 7887.
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Figures
Fig. 1
Descriptive analysis of humeral IO success data.
Abstract
Objective
Studies on humeral placement of the EZ-IO (Vidacare, Shavano Park, TX, USA) have shown mixed results. We performed a study to determine the first-attempt success rate at humeral placement of the EZ-IO by paramedics among prehospital adult cardiac arrest patients.
Methods
A retrospective cohort analysis of data prospectively collected over a 9-month period. Data are a subset extracted from a prehospital cardiac arrest study. The cohort consisted of adult cardiac arrest patients in whom the EZ-IO placement was attempted in the humerus by paramedics. Choice of vascular access was at the discretion of the paramedic; options included tibial or humeral EZ-IO and intravenous. Primary outcome is the percentage of successful placements (stable, flow, without extravasation) on first attempt. Secondary outcomes are overall successful placement, complications, and reason for failure. Data were collected during a post–cardiac arrest interview.
Results
Humeral intraosseous (IO) access was attempted in 61% (n = 247) of 405 cardiac arrests evaluated with mean age of 63 (±16) years, 58% male. First-attempt successful placement was 91%. Successful placement was 94%, considering the second attempts. In the unsuccessful attempts, 2% reported obesity as the cause, 1% reported stable placement without flow, and 2% reported undocumented causes for failure. There were also 2% reports of successful placement with subsequent dislodgement.
Conclusions
The results of this study suggest a high degree of paramedic proficiency in establishment of IO access in the proximal humerus of the out-of-hospital cardiac arrest. Few complications suggest that proximal humeral IO access is a reliable method for vascular access in this patient population.
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☆This project was funded by the Office of the Medical Director for San Antonio Fire Department. Vidacare Corporation also provided supplies and administrative support.
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