title: EZ-IO(®) intraosseous device implementation in a pre-hospital emergency service: A prospective study and review of the literature.
abstract: BACKGROUND
  Intraosseous access is increasingly recognised as an effective alternative vascular access to peripheral venous access. We aimed to prospectively study the patients receiving prehospital intraosseous access with the EZ-IO(®), and to compare our results with those of the available literature.
  
  
  METHODS
  Every patient who required an intraosseous access with the EZ-IO from January 1st, 2009 to December 31st, 2011 was included. The main data collected were: age, sex, indication for intraosseous access, localisation of insertion, success rate, drugs and fluids administered, and complications. All published studies concerning the EZ-IO device were systematically searched and reviewed for comparison.
  
  
  RESULTS
  Fifty-eight patients representing 60 EZ-IO procedures were included. Mean age was 47 years (range 0.5-91), and the success rate was 90%. The main indications were cardiorespiratory arrest (74%), major trauma (12%), and shock (5%). The anterior tibia was the main route. The main drugs administered were adrenaline (epinephrine), atropine and amiodarone. No complications were reported. We identified 30 heterogeneous studies representing 1603 EZ-IO insertions. The patients' characteristics and success rate were similar to our study. Complications were reported in 13 cases (1.3%).
  
  
  CONCLUSIONS
  The EZ-IO provides an effective way to achieve vascular access in the pre-hospital setting. Our results were similar to the cumulative results of all studies involving the use of the EZ-IO, and that can be used for comparison for further studies.
authors.affiliation: Emergency Service, Lausanne University Hospital, Switzerland. David.Santos.Pinto@gmail.com
authors.forename: David
authors.initials: D
authors.lastname: Santos
authors.forename: Pierre-Nicolas
authors.initials: PN
authors.lastname: Carron
authors.forename: Bertrand
authors.initials: B
authors.lastname: Yersin
authors.forename: Mathieu
authors.initials: M
authors.lastname: Pasquier
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000638:Amiodarone / Q000008:administration & dosage; D000700:Analgesics / Q000008:administration & dosage; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage; D001285:Atropine / Q000008:administration & dosage; D001993:Bronchodilator Agents / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D016638:Critical Illness / Q000628:therapy*; D000077324:Crystalloid Solutions; D004632:Emergency Medical Services; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000628:therapy; D017148:Infusions, Intraosseous / Q000295:instrumentation*; D007552:Isotonic Solutions / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000628:therapy; D011446:Prospective Studies; D012128:Respiratory Distress Syndrome / Q000628:therapy; D012769:Shock / Q000628:therapy; D013226:Status Epilepticus / Q000628:therapy; D013977:Tibia; D014947:Wounds and Injuries / Q000628:therapy; D055815:Young Adult
chemical_list: D000700:Analgesics; D000889:Anti-Arrhythmia Agents; D001993:Bronchodilator Agents; D000077324:Crystalloid Solutions; D007552:Isotonic Solutions; D001285:Atropine; D000638:Amiodarone; D004837:Epinephrine