title: Intraosseous infusion: success of a standardized regional training program for prehospital advanced life support providers.
abstract: OBJECTIVE
  To evaluate a standardized training program in intraosseous (IO) infusion for prehospital providers.
  
  
  METHODS
  Prospective multicenter 24-month study.
  
  
  METHODS
  IO infusions were performed by prehospital providers from eight advanced life support units serving 14 hospitals within nine counties.
  
  
  METHODS
  Field advanced life support providers (paramedics and registered nurses).
  
  
  METHODS
  All providers participated in a one-hour standardized training session and supervised hands-on simulation. Providers completed a data sheet on all IO infusions performed. Data sheets were collected and summarized.
  
  
  RESULTS
  One hundred thirty-four prehospital providers completed the training session and were approved to perform the procedure. Fifteen patients requiring IO infusion were encountered during the study period. Thirteen (87%) had IO infusion completed successfully. Clinical indications included 11 patients in cardiac arrest, two trauma resuscitations, one seizure, and one toxic ingestion. Patient ages ranged from 1 to 24 months. Seven patients were initially resuscitated. Four survived to hospital discharge. Procedural complications included one incidence of local fluid extravasation and one IO line that became dislodged en route. There were no complications at time of discharge in the four survivors. All procedures were performed in less than two minutes.
  
  
  CONCLUSIONS
  A one-hour standardized training session was successfully used to train prehospital providers in the procedure of IO infusion. IO infusion then was implemented into their clinical practice with a satisfactory success rate and few complications.
authors.affiliation: Departments of Emergency Medicine, Chambersburg Hospital, PA.
authors.forename: T E
authors.initials: TE
authors.lastname: Anderson
authors.forename: K
authors.initials: K
authors.lastname: Arthur
authors.forename: M
authors.initials: M
authors.lastname: Kleinman
authors.forename: R
authors.initials: R
authors.lastname: Drawbaugh
authors.forename: D R
authors.initials: DR
authors.lastname: Eitel
authors.forename: C S
authors.initials: CS
authors.lastname: Ogden
authors.forename: D
authors.initials: D
authors.lastname: Baker
mesh_terms: D002675:Child, Preschool; D004632:Emergency Medical Services; D004634:Emergency Medical Technicians / Q000193:education*; D016529:Emergency Nursing / Q000193:education*; D005069:Evaluation Studies as Topic; D006801:Humans; D007223:Infant; D017148:Infusions, Intraosseous; D007318:Inservice Training; D008020:Life Support Care; D010414:Pennsylvania; D011446:Prospective Studies; D012041:Regional Medical Programs