Emergency Burr Hole utilizing the EZ-IO™ drill: A pilot cadaver study

Delayed surgical care increases mortality and worsens neurologic outcomes in patients with an Epidural Hematoma (EDH) that are deteriorating and showing signs of herniation or coma [ , , , ]. This procedure and the equipment used are rarely encountered in the Emergency Department (ED) and may not be as familiar to the Emergency Medicine Physician as the EZ-IO™ (EZ-IO™, Teleflex) drill they commonly use to obtain intraosseous (IO) access. There now have been two case reports describing the use of the EZ-IO™ drill in lieu of the traditional Emergency Burr hole procedure in patients with an EDH who are rapidly deteriorating and emergency surgery is unavailable. Bulstrode et al. in 2017 published a case report of a patient with an EDH where a neurosurgeon utilized the EZ-IO™ drill to drain an occipital site EDH [ ]. Then in 2018, Durnford et al. described the second case using an EZ-IO™ drill to drain a rapidly expanding EDH, this time in a rural hospital by an Emergency Medicine Physician with neurosurgeon guidance over the telephone [ ]. Outside of these two case reports there is little evidence defining this novel procedure.