Consecutive field trials using two different intraosseous devices

Objective. Establishing traditional intravenous (IV) access in adult trauma and medical patients can be difficult. We evaluated provider performance for obtaining intraosseous access with two FDA-approved intraosseous devices (F.A.S.T. 1™ and EZ-IO®) in two sequential field trials. Methods. One hundred twenty-four providers consented to participate in the first field trial evaluating the use of the F.A.S.T. 1™ system. Three hundred eighty-nine providers consented to participate in the second field trial, evaluating the use of the EZ-IO. Following each insertion attempt, a telephone data collection process with a member of the research team was completed. Insertion success rate and measures of provider comfort and satisfaction with each device were collected and analyzed. Results. One hundred seventy-eight insertions (89 F.A.S.T. 1™; 89 EZ-IO®) were completed between February 2000 and December 2005. Sixty-four of the 89 insertions of the F.A.S.T. 1™ were successful, and 78 of the 89 insertions of the EZ-IO® were successful (72% vs. 87%; χ² = 6.8; p = 0.009). Providers using the F.A.S.T.1™ attempted more IV insertions prior to using the IO device than the providers using the EZ-IO (2.6 vs. 2.0, p = 0.005). There were no differences in provider comfort or provider assessed device performance between the two devices (p = 0.52; p = 0.13, respectively). Conclusion. In our comparison of two field trials of prehospital provider use of the F.A.S.T.1™ and EZ-IO® systems, more successful insertions with the EZ-IO® were achieved than with the F.A.S.T.1™ device. Limitations of our comparison include nonrandomization, the sequential field trial design, the potential for a learning effect, and self-reporting of data points by providers. A prospective, randomized evaluation of these devices is warranted to draw definitive conclusions about provider insertion success rate with these devices.