It’s been less than two months since the Los Angeles County Fire Department instituted its Intraosseous (IO) Pilot Program, and so far, it’s been a “resounding success,” according to Dr. Clayton Kazan, the Department’s medical director.
“We’ve had no bad outcomes from it at all,” Kazan said. “The feedback on it has been tremendous.”
Usually, paramedics will use intravenous (IV) access, where a needle is inserted into a patient’s vein so paramedics can directly inject fluid or medication. IO access allows paramedics to inject the same substances into a person’s body via bone marrow space.
IO access is obtained through the tibia, one of the bones in a person’s leg. Paramedics use a “kind of drill that drills a special needle through the outside of the bone into where the bone marrow space is,” Kazan explained. “The bone marrow space connects directly to the venous system, so you can use it exactly like you use an IV.”
Paramedics are permitted to use IO access in certain circumstances, including in adult and pediatric patients in cardiopulmonary arrest when IV access is not possible, unlikely to be successful or cannot be achieved within two attempts or 90 seconds.
“So far, the feedback has been universally strong,” Kazan said. “I have yet to hear one negative comment, other than, ‘We had a problem, and we had to switch and do it on the other side.’ … Everybody has been really happy with it.”
The pilot program, which began Nov. 1, is being conducted with the Department of Health Services.
Though other fire departments already use IO access for cardiac arrest, “we are the first one that is now permitted to do it in live patients that are comatose and in what’s called hypovolemic shock,” Kazan said.
“It is the first opportunity we’ve had to do a pilot study with DHS in a long time,” he said. “We are blazing the (EMS) trail again—we are leading the way again. Hopefully (it’s) the first step of many things we lead.”
Featured image: File photo of Squad 30. Photo by volunteer photographer Derek Cutler.