Don't Forget the Fastest Vascular Access for Trauma

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For trauma (or any) patients arriving in extremis, the IO route was fast and had a very high success rate compared to peripheral IV or central line.

Why does this matter?
Obtaining IV access is critical for trauma resuscitation.  We often forget about the IO route.  This article helps us break out of our tunnel vision and reminds us there is another viable option for access.

IO, IO. It's off to work we go...
This was a video review of 38 patients in extremis, defined as arrival with no palpable pulse or measurable blood pressure, and vascular access attempted.  Of these 38, 93% were from penetrating trauma; 145 vascular access attempts were made.  Peripheral IV (PIV) and IO were statistically the same regarding time to access, about 20-40 seconds.  Central venous catheters (CVC) took about 3 minutes.  IO success was 95%; PIV 42%; CVC 46%.  Don't forget about this highly successful and rapid way to gain vascular access in severely ill patients.

Source
The intraosseous have it: A prospective observational study of vascular access success rates in patients in extremis using video review.  J Trauma Acute Care Surg. 2018 Apr;84(4):558-563. doi: 10.1097/TA.0000000000001795.

Peer reviewed by Thomas Davis

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