EJ or IO during a full arrest?

emtchick171

emtchick171

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Just wondering who prefers an EJ or IO during a cardiac arrest...

In our protocol we can use either in an emergent situation, I prefer the IO...just wondering what everyone else likes and what makes you prefer it?

All feedback is appreciated.
 
Protocol for the company I am going to school at is an IO. Easier and faster is the thought process.
 
NVRob said:
Protocol for the company I am going to school at is an IO. Easier and faster is the thought process.
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I agree with that, do y'all use the leg IOs or sternal IOs?
 
We go leg, then arm if you can't gain access in the leg for some reason, I'd have to look again but I believe sternals are bad juju in our protocols.
 
NVRob said:
We go leg, then arm if you can't gain access in the leg for some reason, I'd have to look again but I believe sternals are bad juju in our protocols.
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That's good to know, just to see how EMS systems vary...the only way we do leg IO is with pediatrics, and...if our PT is over the age of 12, they get the sternal IO. We have had wonderful success with our sternal IO system.
 
We always go with the IO. It's much quicker and the 1st attempt success rate is higher than EJ. We use 2 sites for adults, distal tibia and proximal humerous. On pediatrics we use the proximal tibia.
 
Suffolk County IO protocol is good for proximal tibia only. As for my choice I'll take IO, faster and easier. Hence the name EZ-IO which is what we use on my FD. I'm sure the commissioners would love if I we got better acquainted with doing EJ's as those IO needles are a bit on the pricey side.
 
citizensoldierny said:
Suffolk County IO protocol is good for proximal tibia only. As for my choice I'll take IO, faster and easier. Hence the name EZ-IO which is what we use on my FD. I'm sure the commissioners would love if I we got better acquainted with doing EJ's as those IO needles are a bit on the pricey side.
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Ohhh yes the IO needles are definitely on the pricey side, but I haven't been on a call yet *knock on wood* that a sternal IO was not successful. We have great success rates with them, as for the tibia...we RARELY do one of these, we have the adult needles to use for the tibia but we have found that the sternal works much better!
 
EJs and IOs both allow adequate flow for use in a cardiac arrest, so its really just a matter of how quickly you can do each one, since time is everything.
 
In our protocols we can use EJ or EZ-IO.
I prefer the EZ-IO, Tibia proximal aera, but tibia distal or humerus
I never tried it...
Matt
 
IV works well, our Paramedics can do an EJ whereas Intensive Care (ALS) has IO.
 
for the OP, how well does a sternal IO work with CPR? i dont think i would even try. my county has IO for peds only, i have not had any CA yet where i could not get an IV. if there are no viens we can go IL (intra lingual) with the epi and atropine.
 
I think every medic is able to get an iv line, but sometimes you haven't soo much time (90sec. for iv line isn't much time) so EZ-IO or BIG are very fast and easy every doctor can learn this too B)
Matt
 
IO over EJ unless it is the sternal IO. Sorry, but in a code I want as little as possible in the way. We c-collar all of our intubated patients, and c-collars don't get along with the sternal IOs.
 
Its provider choice in our area. EJs are beautiful 'dead' people veins, plumped up and ready to stab. Personally, its whatever I can get quicker in my hand and ready.... which lately, has been the IV cath. I/Os are in the humeral head. If that fails, its free game.
 
I have my choice. For IO we use the EZ and can do either humoral or tibial. It all depends on what I see when I take a look
 
I've never had a sternal IO get in the way during CPR (other than when it was being inserted).
 
emtchick171 said:
Just wondering who prefers an EJ or IO during a cardiac arrest...

In our protocol we can use either in an emergent situation, I prefer the IO...just wondering what everyone else likes and what makes you prefer it?

All feedback is appreciated.
Click to expand...
I use Intraosseous infusion often, it works exceptionally well in low light and austere environments. The "sternal Intraosseous method" also works well but can prove to be dangerous to the PT if there is an chance of unstable CX Fx. I agree with other posters EJ are wonderful "dead people" veins however we do what is best for the PT and best for the PT is needed treatment. Also we use 0.5mg-1.0mg/kg (100mg ;-) of lidocaine for living/alert non obtunded Pt's.

Just my .05 cents.
 
Boston.Tacmedic said:
I use Intraosseous infusion often, it works exceptionally well in low light and austere environments. The "sternal Intraosseous method" also works well but can prove to be dangerous to the PT if there is an chance of unstable CX Fx. I agree with other posters EJ are wonderful "dead people" veins however we do what is best for the PT and best for the PT is needed treatment. Also we use 0.5mg-1.0mg/kg (100mg ;-) of lidocaine for living/alert non obtunded Pt's.

Just my .05 cents.
Click to expand...


I appreciate everyones feedback. I think its interesting to hear how in each area/department protocols for IO/EJ, etc. differ. I agree with the danger to the PT if there is a chance of Fx...but so far we have not ran into anything that has caused a problem with us using a sternal IO. *knock on wood* We also just recently (within the last 2 days) received the IO drills which will make matters much easier for us, rather than having to do everything manual.
 
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