Comparison of two intraosseous infusion systems for adult emergency medical use.
BACKGROUND
The current guidelines of the European Resuscitation Council (ERC) stipulate that an intraosseous access should be placed if establishing a peripheral venous access for cardiopulmonary resuscitation (CPR) would involve delays. The aim of this study was therefore to compare a manual intraosseous infusion technique (MAN-IO) and a semi-automatic intraosseous infusion system (EZ-IO) using adult human cadavers as a model.


METHODS
After receiving verbal instruction and giving their written informed consent, the participants of the study were randomized into two groups (group I: MAN-IO, and group II: EZ-IO). In addition to the demographic data, the following were evaluated: (1) Number of attempts required to successfully place the infusion, (2) Insertion time, (3) Occurrence of technical complications and (4) User friendliness.


RESULTS
Evaluation protocols from 84 study participants could be evaluated (MAN-IO: n=39 vs. EZ-IO: n=45). No significant differences were seen in the study participants' characteristics. Insertion times (MW+/-S.D.) of the respective successful attempts were comparable (MAN-IO: 33+/-28s vs. EZ-IO: 32+/-11s). When using the EZ-IO, the access was successfully established significantly more often on the first attempt (MAN-IO: 79.5% vs. EZ-IO: 97.8%; p<0.01). The EZ-IO was also found to have more advantages in terms of technical complications (MAN-IO: 15.4% vs. EZ-IO: 0.0%; p<0.01) and user friendliness (school grading system: MAN-IO: 1.9+/-0.7 vs. EZ-IO: 1.2+/-0.4; p<0.01).


CONCLUSIONS
In an adult human cadaver model, the semi-automatic system was proven to be more effective. The EZ-IO gave more successful results, was associated with fewer technical complications, and is user friendlier.
Department of Anaesthesiology and Emergency Medicine, University of Heidelberg, D-69120 Heidelberg, Germany.
Thorsten
T
Brenner
Michael
M
Bernhard
Matthias
M
Helm
Sara
S
Doll
Alfred
A
Völkl
Nicole
N
Ganion
Claudia
C
Friedmann
Marcus
M
Sikinger
Jürgen
J
Knapp
Eike
E
Martin
André
A
Gries
D000328:Adult; D001291:Attitude of Health Personnel; D002102:Cadaver; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005240:Feasibility Studies; D006801:Humans; D017148:Infusions, Intraosseous / Q000009:adverse effects / Q000295:instrumentation*; D008954:Models, Biological; D012151:Resuscitation / Q000295:instrumentation*; D013997:Time Factors