Therapeutic Hypothermia via IO

[MasterIntubator]

Sooooo I did a little looking around on Google about the efficiency of cold saline going via IO.... and most articles state its less efficient compared to IV infusion, and much of it was older info. Which makes sense based on pathology.
Anyone have any intel on new studies about that? Or even actual experience?
For those who have it, and protocols... does it state whether it should be IV only, or can it include an IO?

 

[TomB]

Wake County EMS, North Carolina allows iced saline to be given IO.

 

[MasterIntubator]

IO only... or as an option?

 

[J. Burdett]

I've seen it done once on a pt experiencing malignant neuroleptic syndrome. Pt had a temp of 104 w/ horrible venous access. If I recall correctly the pt was given dantrolene shortly afterwards, before administration the temp had been reduced slightly.

 

[Fox800]

Our protocol is IV or IO. Standard procedure on cardiac arrests is bilateral IO's, we don't even attempt IV's unless something juicy is right there. It's faster and a sure thing.

 

[MasterIntubator]

Bilateral IOs... no kidding. You would think one would be enough. On the other token.... is that in place so that you can hand 2 bags of chilled fluids enhancing their cooling experience? Sounds credible... does it bring the pts temp down in a decent amount of time?

 

[reaper]

Yes, Ours allow IV or IO administration.

Haven't you ever heard the phrase "Chilled to the bone"!

 

[Hockey]

IO's are rare and looked downupon by some it seems around here. With my IV crappiness lately, I wish IO's for all

 

[jjesusfreak01]

IO only... or as an option?

If you're asking about Wake County, either is acceptable, but IO might be more likely. The primary line on a code blue patient is probably going to be an IO, since you won't be able to easily get an IV. Post ROSC, there may be time for an IV, but we only cool a few degrees (and arrested patients cool down), so by the time we have an IV its usually no longer necessary to cool the patients.