IO versus IV access while wearing personal protective equipment in a HazMat scenario.
Prehospital Emergency Care · 2007-01-01 · Observational study
Abstract
OBJECTIVE: Determine the time difference obtaining intraosseous (IO) versus intravenous (IV) access while wearing personal protective equipment (PPE) in simulated HazMat scenarios. METHODS: Twenty-two EMT-P providers established anterior tibial IO access using the EZ-IO system and routine antecubital IV access in three mannequin and PPE HazMat scenarios: 1) provider and mannequin not in PPE, 2) only provider in Level C PPE, and 3) provider and mannequin both wearing Level C PPE. Primary outcome measures were the average time in seconds for skin access, vascular access, and fluid infusion with each method in these configurations. RESULTS: For the provider and mannequin not in PPE condition, needle to skin time favored the IV (6.2 vs. 9.3 seconds; p < 0.001). whereas vascular access time (12.8 vs. 36.3 seconds; p < 0.001) and fluid infusion time (26.2 vs. 36.5 seconds; p = 0.02) favored the IO approach. For the provider in PPE and mannequin not in PPE condition, needle to skin times were similar for IO and IV (10.4 vs. 12.7 seconds; p = 0.591), whereas vascular access time (14.0 vs. 46.0 seconds; p < 0.001) and fluid infusion time (28.3 vs. 45.7 seconds; p < 0.001) both favored the IO approach. With the provider and mannequin in PPE, needle to skin time (12.7 vs. 24.9 seconds; p < 0.001), vascular access time (16.9 vs. 62.7 seconds; p < 0.001), and fluid infusion time (29.5 vs. 66.1 seconds; p < 0.001) all favored the IO approach. Fluid infusion times for the provider not in and in PPE (26.2 vs. 28.3 seconds; p < 0.05) with the mannequin not in PPE revealed no significant time burden associated with using the EZ-IO device with the provider in PPE. CONCLUSIONS: Overall, the EZ-IO system under HazMat conditions provides vascular access and fluid more quickly than standard intravenous access. When providers and mannequins were both in PPE, the time differential between IO and IV access was the greatest, favoring the IO approach. Donning PPE did not hinder the providers' use of the EZ-IO device and may be useful for obtaining vascular access when wearing PPE.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Intraosseous access · Intravenous access · Paramedics & EMTs · Personal protective equipment
Related articles
- CBRNe Personal Protective Equipment Is Not a Hindrance to Lifesaving Procedures in Prehospital Settings: A Prospective, Repeated-Measures Observational Study. (Epidemiologia (Basel), 2025)
- Pediatric intravascular access in simulated COVID-19 patients among paramedics wearing personal protective equipment. (Resusc Plus, 2021)
- Impact of chemical, biological, radiation, and nuclear personal protective equipment on the performance of low- and high-dexterity airway and vascular access skills. (Resuscitation, 2009)
- Vascular access by paramedics during cardiopulmonary resuscitation in out-of-hospital cardiac arrest: A retrospective study of insertion success rates and survival outcomes of intravenous versus intraosseous route. (Am J Emerg Med, 2026)
- Comparison of intravascular access methods applied by nurses wearing personal protective equipment in simulated COVID-19 resuscitation: A randomized crossover simulation trial. (Am J Emerg Med, 2021)
- Life-Saving Procedures Performed While Wearing CBRNe Personal Protective Equipment: A Mannequin Randomized Trial. (Simul Healthc, 2021)