EZ-IO(®) intraosseous device implementation in a pre-hospital emergency service: A prospective study and review of the literature

Resuscitation. 2013 Apr;84(4):440-5. doi: 10.1016/j.resuscitation.2012.11.006. Epub 2012 Nov 14.


Introduction: Intraosseous access is increasingly recognised as an effective alternative vascular access to peripheral venous access. We aimed to prospectively study the patients receiving prehospital intraosseous access with the EZ-IO(®), and to compare our results with those of the available literature.

Methods: Every patient who required an intraosseous access with the EZ-IO from January 1st, 2009 to December 31st, 2011 was included. The main data collected were: age, sex, indication for intraosseous access, localisation of insertion, success rate, drugs and fluids administered, and complications. All published studies concerning the EZ-IO device were systematically searched and reviewed for comparison.

Results: Fifty-eight patients representing 60 EZ-IO procedures were included. Mean age was 47 years (range 0.5-91), and the success rate was 90%. The main indications were cardiorespiratory arrest (74%), major trauma (12%), and shock (5%). The anterior tibia was the main route. The main drugs administered were adrenaline (epinephrine), atropine and amiodarone. No complications were reported. We identified 30 heterogeneous studies representing 1603 EZ-IO insertions. The patients' characteristics and success rate were similar to our study. Complications were reported in 13 cases (1.3%).

Conclusion: The EZ-IO provides an effective way to achieve vascular access in the pre-hospital setting. Our results were similar to the cumulative results of all studies involving the use of the EZ-IO, and that can be used for comparison for further studies.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Amiodarone / administration & dosage
  • Analgesics / administration & dosage
  • Anti-Arrhythmia Agents / administration & dosage
  • Atropine / administration & dosage
  • Bronchodilator Agents / administration & dosage
  • Child
  • Child, Preschool
  • Critical Illness / therapy*
  • Crystalloid Solutions
  • Emergency Medical Services*
  • Epinephrine / administration & dosage
  • Female
  • Humans
  • Hypoglycemia / therapy
  • Infusions, Intraosseous / instrumentation*
  • Isotonic Solutions / administration & dosage
  • Male
  • Middle Aged
  • Out-of-Hospital Cardiac Arrest / therapy
  • Prospective Studies
  • Respiratory Distress Syndrome / therapy
  • Shock / therapy
  • Status Epilepticus / therapy
  • Tibia
  • Wounds and Injuries / therapy
  • Young Adult


  • Analgesics
  • Anti-Arrhythmia Agents
  • Bronchodilator Agents
  • Crystalloid Solutions
  • Isotonic Solutions
  • Atropine
  • Amiodarone
  • Epinephrine