Fire EMS, Firefighter Training

Intraosseous Access: What’s Out There?

Issue 2 and Volume 168.

BY CONNIE PIGNATARO Emergency medical services (EMS) have grown considerably since our humble beginnings in the late 1960s and early 1970s. Cardiopulmonary resuscitation, endotracheal intubation, and intravenous (IV) therapy are among the interventions and therapies that were in their infancy in EMS and continued to develop and advance through numerous studies and clinical trials. Gaining vascular access is crucial to administer resuscitation medications and fluids to critically ill patients. In many cases, especially with critical patients, veins tend to collapse and be unavailable for paramedic access. Intraosseous (IO) vascular access became the solution to this problem. IO access was introduced in 1922, but it did not gain in popularity until the 1980s.1 IO access was frequently used to administer drugs to children during the 1940s. During the 1950s and 1960s, a more practical disposable IV catheter was created, as were improved insertion techniques. IOs lost their popularity until the 1980s,…

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