# Io



## babygirl2882 (Dec 9, 2007)

So I'm not sure if this is a ALS thing but I'm pretty sure it is. IO's do you do them or not? And if you do, do you use the EZ IO?


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## katgrl2003 (Dec 9, 2007)

IO's are strictly ALS. Our company has been using the EZ IO for a few months now.


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## medic001918 (Dec 9, 2007)

Have them and do them regularly.  We have the EZ-IO for adult and pediatrics.  And if an IO is used, it without question should be being performed by a paramedic.

Shane
NREMT-P


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## KEVD18 (Dec 10, 2007)

our chair van drivers do ez-io's here.


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## Doctor B (Dec 10, 2007)

We have been utilizing the EZ-IO for a bout two years now. We evaluated all three IO devices and even though the cost for the EZ-IO is a bit more than the other devices there is simply no substitute for contol of the needle. And with the FDA recently adding the humerus as an approved site there is no other device that is as versatile either.


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## BBFDMedic28 (Dec 10, 2007)

I work for AMR SA and we have had the EZ IO for awhile. Our protocalls say we are to use the EZ IO on adults only. The pedi needles still have to be put in manually.


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## MSDeltaFlt (Dec 10, 2007)

My company uses the EZ-IO, and have found that the Pedi use is sensitive to dislodging on slight vibration.  They're working on an improved stabilizing unit.


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## VinBin (Dec 10, 2007)

KEVD18 said:


> our chair van drivers do ez-io's here.



nice...
I guess Medicare was right, they didn't need an ambulance...


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## eggshen (Dec 11, 2007)

We use EZ-IO for peds and adult. I love it. Way better than Jamshidi or Cook by a mile.


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## johnrsemt (Dec 12, 2007)

The private service I work with (along with Katgirl); uses EZ IO for adults and manual for peds.
  the 911 service I work for uses the 'BIG'  IO for both, different strenght for peds of course.  

  I have used both and like both.   haven't decided which is my favorite yet.


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## Mr. Anderson (Dec 12, 2007)

My fire department has the EZ-IO for peds and adults with the manual as a backup plan. The flight program I work for has the manual needles for when things really go wrong, the sternal as an option, and EZ-IO as the prefered method for both peds and adults.

Having used all three, my opinion is that the EZ-IO is the far superior tool.


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## Mr. Anderson (Dec 12, 2007)

BBFDMedic28 said:


> I work for AMR SA and we have had the EZ IO for awhile. Our protocalls say we are to use the EZ IO on adults only. The pedi needles still have to be put in manually.



Just out of curiosity, why would you not use the EZ-IO for peds. I would think the speed of insertion, and the lack of lateral movement sometimes found with manual insertion would make the drill the first choice for peds.


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## RALS504 (Dec 13, 2007)

Here in this state pedi IO is an EMT-I skill after 90 seconds of searching for IV sites or 2 failed IV attempts. Intermediates are not allowed to do adult IO.


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## johnrsemt (Dec 13, 2007)

the service I work at that uses the EZ hasn't bought the Pedi needles.  I am considering buying them for me to use there, if they arent too expensive.


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## Doctor B (Dec 13, 2007)

johnrsemt said:


> the service I work at that uses the EZ hasn't bought the Pedi needles.  I am considering buying them for me to use there, if they arent too expensive.



The replacement needles typically run between $90-110.00 ea and typically only come 5 in a box. Some places will sell them individually though. But be careful, taking matters into your own hands without a written protocol can potentially set you up for liability issues. Make sure it's identified in your protocols that you can indeed use the EZ-IO insertion device for placement of the peds IO before you make the purchase.


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## medicdan (Dec 14, 2007)

Does anyone here use the BIG (Bone Injection Gun)? As I was stocking the Natan this morning I saw them-- what are the differences v. EZ-IO, other then not needing to check the battery? One of the paramedics told me that MDA did an internal study of BIG v. EZ-IO, and found that the BIG was more precise (not quite sure what that means), as well as cheaper.


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## Mr. Anderson (Dec 14, 2007)

Never used the BIG on an actual patient.....barbaric. Nothing beats the EZ-IO: ease of insertion, pretty darn precise as long as your hand doesn't slip, and can flow as much as a central line. Check the webpage for links to clinical studies: http://www.vidacare.com


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## Doctor B (Dec 14, 2007)

emt-student said:


> Does anyone here use the BIG (Bone Injection Gun)? As I was stocking the Natan this morning I saw them-- what are the differences v. EZ-IO, other then not needing to check the battery? One of the paramedics told me that MDA did an internal study of BIG v. EZ-IO, and found that the BIG was more precise (not quite sure what that means), as well as cheaper.



Not sure how they justify the device as being more precise. While the BIG is cheaper than the EZ it doesn't afford you the ability to "feel" the needle enter the Intraosseous space when inserting it. It's simply a matter of placing the device on the patient and pulling the trigger hoping that it went through but not too far. My concern would also be with the velocity of the needle and if it glances off the bone it could potentially splinter it as well. From a pt. transfer standpoint the receiving facility would also need the removal device for the BIG if you choose to go that direction. Just my .02 but while the EZ is a bit more expensive it is more versatile and IMO the more precise device with more FDA approved insertion sites.


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## paramediclori (Dec 22, 2007)

KEVD18 said:


> our chair van drivers do ez-io's here.



What the hell?  I guess I am not sure what an EZ IO is, but yes, all IO's are to be done by paramedics, and I don't know about all of you guys, but I HATE the feeling of doing an IO.


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## medic001918 (Dec 23, 2007)

I don't feel a thing when I do them.  We use the IO drill so it takes only a second to have an IO placed in an adult or a pedi.  We use them from line in cardiac arrest, and we can use them after two or three failed attempts in a critical patient.

Shane
NREMT-P


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## Ridryder911 (Dec 23, 2007)

Ditto... kinda like I tell my patients when I start IV's; "_I've done this all day, and it is as of yet, hurt me!"..._

Love the EZ I/O's.. I used FAST, on the helicopter when they first came out. They were okay, but not as good as EZ's. I have started EZ on conscious patients and they rated the pain as about the same as peripheral sticks. 

EZ I/O web site even has a video of a physician establishing one on another physician. Not even a flinch...

paramediclori, since you do not use EZ, what do you use on adult I/O's ? 

R/r 911


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## paramediclori (Dec 23, 2007)

Hmm,.. I guess I am not sure of the type we use, .... as I didn't realize there were a few different ones, I will have to look into it and find out, or do you have a website that shows the different types, and I could find out that way too?


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## babygirl2882 (Dec 23, 2007)

what does IO stand for?


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## Ridryder911 (Dec 23, 2007)

babygirl2882 said:


> what does IO stand for?


Intraosseous infusion- which is an specific needle (bone marrow, spinal needle, I/O needle) that goes into the bone for an I.V.  It was used in the early 40's until plastic caths were invented, then became popular again for use in pediatrics in the late 80's and now have returned to adults in the past five-ten years. AHA now recommends adult I/O in lieu of placing medications through the Endotracheal tube. So basically, if one cannot obtain an IV, a I/O is warranted. 




paramediclori said:


> Hmm,.. I guess I am not sure of the type we use, .... as I didn't realize there were a few different ones, I will have to look into it and find out, or do you have a website that shows the different types, and I could find out that way too?



Please, don't take offense; but you are a Paramedic but don't know what type of device you use? hmmmm... ?

As well where have you been? I/O placement in adults have been taught and required in ACLS for the past two years and as well been popular topic in EMS discussions for the past 5-7 years. 

There is the traditions shank type for adults (upper tibia, like ped.'s), then there is the  B-I-G  gun for tibia (ped & adult), as well as FAST that is strictly sternal as well, and of course EZ-I/O which is tibia, and upper humerus (which also can be used in pediatric tibia) 

http://www.waismed.com/

http://www.pyng.com/

http://www.vidacare.com/

R/r 911


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## paramediclori (Dec 23, 2007)

Ridryder911 said:


> Please, don't take offense; but you are a Paramedic but don't know what type of device you use? hmmmm... ?
> 
> As well where have you been? I/O placement in adults have been taught and required in ACLS for the past two years and as well been popular topic in EMS discussions for the past 5-7 years.
> 
> ...




I know how to use and where an IO goes thank you.  I was just confused on which "brand" if you will you were talking about.  I looked at those links and those are not what we use here, hence my confusion.  I have always been around the same brand of IO's, there for that is what I know, I am not sure which kind it is.  I can assure you it is an older style.  Please remember, I hate it here in Michigan, they are A LOT further behind in technology then most other states.  Example, most places around here have just switched to 12 leads this year   Please don't take that out on me, I am looking to move out of state to learn more and better myself.  I will ask at work tomorrow which IO it is that we carry, and get back with you.


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