I concur with Todd.  We and have had an EZ-IO for approx 1 yr and our EMS a
little longer.  I have been involved in its use at least 10 times and nearly
half "popped" out.   All of these were on chunky toddlers.   My practice now
is to use the "adult" in all patients except neonates.  I also agree that a
slightly larger "platform" at the hub would greatly enhance securing of the
device.   Other than this, I have found the EZ-IO to be remarkably easy to
use and adopt.

Matt Greenberg
Bethel, Alaska

On Tue, Jul 7, 2009 at 8:41 PM, Todd Chang <[log in to unmask]> wrote:

> It appears from the majority of the posts that the automated IO system
> (e.g. EZ-IO) has
> been adopted easily.  At our institution, our ED has switched to the EZ-IO
> system with
> relative ease.  Collectively we've placed around 60 - 80 EZ-IO insertions
> since adopting it
> in 2007, and the technique is rather simple.
> As Dr. Meckler suggests, penetrating soft tissue does not require the
> rotary component,
> and the drill spins for <1sec to 2 sec until marrow space is entered.
>  We've used this
> mostly in coding children with poor access, so I can't comment specifically
> about
> lidocaine; infusing lidocaine with the first saline flush is recommended by
> the company.
> I've encountered two problems unique to the EZ-IO.  One is that the EZ-IO
> needles come
> in two sizes:  too small and just-right.  With the exception of neonates or
> severely
> underweight infants, the smaller needle is often not deep enough to
> penetrate the
> proximal tibia, especially in our more, uh, spherical children.  Often the
> 'adult' size needle
> is required for a 2 year-old infant instead, and it works fine.  Second,
> there is no
> additional method to secure the IO needle to the skin - no extra flange,
> etc.  The IO hub
> is flared out but not flat, so there isn't much surface area to tape it as
> well as I'd like.
> One other note:  during a code in the CT scan (always a great place for
> codes), the ER
> tech (albeit freshly hired) brought the EZ-IO gun with a standard IO needle
> instead of the
> specific EZ-IO needle.  In retrospect, it was humorous (the child did fine
> with the
> standard IO), but the staff needs to be inserviced about always pairing the
> gun with the
> specifically designed IO needles.
> -Todd Chang, MD
> Chief Fellow 2009 - 2010 (PEM)
> Childrens Hospital Los Angeles
> For more information, send mail to [log in to unmask] with the
> message: info PED-EM-L
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