With benefits that far outweigh the disadvantages, we wonder why resistance to IO persists. We wonder why we don’t have the courage to step out of our comfort zones? We wonder how we can continue to justify not using IO when indicated. Clearly our professional ethics demand that we adjust to new technologies despite our comfort with the old. Our patients deserve the best from us, and we can and should deliver it to them.

We call upon emergency nurses and physicians alike to work together to implement IO as a standard method of vascular access in EDs across the country. We call upon them to dispel the myths of IO and promulgate the truths. We call upon them to educate and teach their peers. We call upon them to become the local champions and lead their facilities toward the improved safety and outcomes that IO offers. We call upon the Deans of Nursing and Medical Schools to include IO in the curricula for their students. And we call upon the residency program directors in emergency medicine, pediatrics, internal medicine, family practice, and other disciplines to include IO in the training of their residents.

Our patients deserve the benefits IO access can deliver, and we owe it to them to become knowledgeable, familiar, and competent with the technique. Let’s agree to agree for the benefit of our patients and start down that path together. Let’s start today.

References

• Abe K, Blum G, Yamamoto L. Intraosseous is Faster and Easier than Umbilical Venous Catheterization in Newborn Emergency Vascular Access Models. Am J Emerg Med 2000; 18: 126-129.
• Alternative Methods to Vascular Access in the Emergency Department. ACEP Clinical Policy; June 2011.
• Emergency Nursing Resource: Difficult Intravenous Access. ENA; December 2012
• Eng M, Ong H, Chan Y, Oh J, Ngo A. An Observational Prospective Study Comparing Tibial and Humeral Intraosseous Access Using the EZ-IO. Am J Emerg Med 2009; 27: 8 – 15.
• Levitan RM, Bortle CD, Snyder TA, et al. Use of a battery-operated needle driver for intraosseous access by novice users: Skill acquisition with cadavers. Ann Emerg Med. 2009;54:692-694.
• Ong MEH, Chan YH, Oh JJ, Ngo AS-Y. An observational, prospective study comparing tibial and humeral intraosseous access using the EZ-IO. Amer J Emerg Med. 2009;27:8-15.
• Rogers J. Safety of Intraosseous Vascular Access in the 21st Century. Presentation to the 2012 World Congress of Vascular Access.
• Santolucito J. A retrospective evaluation of the timeliness of physician initiated PICC referrals: a continuous quality assurance/performance improvement study. J Vasc Access Devic. 2001;6:20-26.
• Stein J, George B, River G, et al. Ultrasonograhically guided peripheral intravenous cannulation in emergency department patients with difficult intravenous access: a randomized trial. Ann Emerg Med. 2009;54:33-40.
• Stouffer JA, Jui J, Acebo J, Hawks R. The Portland IO experience: results of an adult intraosseous infusion protocol. JEMS. 2007;32:s27-8.
• Vidacare Corporation. Hospital Value Analysis. 2012
• Vizcarra C, Clum S. Intraosseous Route as Alternative Access for Infusion Therapy. Journal of Infusion Nursing 2012; 33:162-174.
• Von Hoff D, Kuhn J, Burris H, Miller L. Does Intraosseous Equal Intravenous? A Pharmacokinetic Study. Am J Em Med 2008; 26: 31-8. Research sponsored by Vidacare.

*Consultant for Vidacare Corporation