ERP’s recent post on the EZ-IO reminded me that I had the opportunity to do my first one of this past week and it was a pretty amazing experience.  If I told you that I was going to take a power drill, sink a drill bit into your bone and the run fluids and medicines into your blood stream through your bone, you’d probably start backing towards the door while asking just exactly how excruciatingly painful is this going to be?  Truth be told, for most people it hurts less than a traditional IV (anecdotally at least). I had this teeny tiny dialysis patient last week, former IV drug user, who needed a line in a bad way. After many attempts by nurses, my attempts by ultrasound, 3 blown IVs, we finally opted to break out the drill. Totally amazing, nearly painless, super easy. Within 10 seconds you have a line, that’s essentially impossible to blow, won’t get jostled out of position, and is essentially worry free.  There are a couple of drawbacks in that it can only stay in for 24 hours, you can’t be admitted with it (at least in our institution) and you can’t get IV contrast through it (yet, but that may be changing). See for yourself. Video really gets started at 1:30

About ER Jedi

I’m a resident doctor in Emergency Medicine and I’ve learned during the past few years that 1) I’ve had some pretty amazing experiences 2) I have a very bad short-term memory. So this blog is just a place for me to write about some of these experiences, from the ER, medical school, the wards and life in general. At least that way I’ll have some idea as to where I’ve been all this time. A scrap-book of sorts, a place to vent, organize some clinical tools and post a few good songs I’ve heard along the way.

Posted on April 20, 2012, in Emergency Medicine. Bookmark the permalink. 7 Comments.

  1. Ever since I heard about EZ-IO I’ve been horrified at the thought. I’ve read that it’s not that painful, but the very thought just turns my stomach. Of course, it’s not like doctors use them for the fun of it — if I needed it I’ll be glad for it I guess.

  2. Fascinating.Finally something really new. Still looks horrible-wonder who thought of it.

    • The army did. And it makes perfect sense for battle field conditions. I’d hate to have to try to cannulate a vein under gunfire, and you can actually place it through clothing if needed. They also place their’s in the sternum which is pretty much idiot proof.

  3. I’d add that when you’re using it on a conscious or semi-conscious patient you should, just prior to flushing, add 20-40mg of cardiac lidocaine nice and slow to numb the intraosseous space. Flowing fluids through an IO is painful for the awake patient. Otherwise, it is quite the tool! Our service is familiar with it in both responsive and unresponsive patients, I’d say the worst part of it for most of them is explaining it 🙂

    • We primed our line with 1% lido and used it as our flush, but even with the initial marrow aspiration, she had not complaints at all.

      • Nice! We’ve not had complaints from our responsive patients who’ve received IO’s…but they were not what one would call stable. Florid pulmonary edema seems to change your perception of “pain”.

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