Intraosseous Access


Sepsis Kills a Patient in the U.S. Every 2.3 Minutes.1

Overall, it kills more than AIDS and breast, colon, pancreatic, and prostate cancer combined.2,3 But as many as 80% of sepsis deaths could be prevented with rapid diagnosis and treatment.4

Early Detection and Rapid Intervention


 

Time to fluids

  • IV fluid resuscitation initiation administered within 30 minutes may decrease sepsis mortality rates and hospital length of stay5

 

Time to IV antibiotics

  • Early antibiotics—ideally within the first hour—make a difference6
  • A study has shown that mortality increases 7.6% for every hour of delay in IV antibiotics4

Clinical Support


Title: Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016
Authors: Rhodes A, Evans LE, Alhazzani W et al.
Publication: Intensive Care Med 2017:1-74. DOI: 10.1007/s00134-017-4683-6.

Excerpt:
“While establishing vascular access and initiating aggressive fluid resuscitation are very important when managing patients with sepsis or septic shock, prompt IV infusion of antimicrobial agents is also a priority. This may require additional vascular access ports. Intraosseous access, which can be quickly and reliably established (even in adults), can be used to rapidly administer the initial doses of any antimicrobial.”

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While the articles support intraosseous vascular access indications, claims and applications of Arrow EZ-IO Intraosseous Vascular Access System, readers should consult a physician and product labeling for proper indications, contraindications, warnings and precautions prior to use.

Potential complications may include local or systemic infection, hematoma, extravasations, or other complications associated with percutaneous insertion of sterile devices.

References:

  1. Marik PE. Surviving sepsis: going beyond the guidelines. Ann Intensive Care. 2011. doi:10.1186/2110-5820-1-17.
  2. HIV in the United States: at a glance. Centers for Disease Control and Prevention Website. http://www.cdc.gov/hiv/statistics/basics/ataglance.html. Updated September 9, 2019. Accessed September 9, 2019.
  3. American Cancer Society Website. Cancer Facts & Figures 2019. https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/cancer-facts-figures-2019.html. Accessed September 9, 2019.
  4. Kumar et al. Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med. June 2006;34(6)1589-96.
  5. Leisman D, Wie B, Doerfler M, et al. Association of fluid resuscitation initiation within 30 minutes of severe sepsis and septic shock recognition with reduced mortality and length of stay. Annals of Emergency Medicine. September 2016;68(3):298-311. doi: 10.1016/j.annemergmed.2016.02.044
  6. Dellinger, R. The Surviving Sepsis Campaign 2014: An Update on the Management and Performance Improvement for Adults in Severe Sepsis. Consultation. October 2014;54(10);2906.
  7. Based on Adult Proximal Humerus EZ-IO insertion data.
  8. Compared to single lumen CVCs.
  9. Hoskins SL, Zachariah BS, Copper N, Kramer GC. Comparison of intraosseous proximal humerus and sternal routes for drug delivery during CPR. Circulation 2007; 116:II_993. Research sponsored by Teleflex Incorporated. (preclinical study)
  10. Hoskins SL, Nascimento P Jr., Lima RM, Espana-Tenorio, JM, Kramer GC. Pharmacokinetics of intraosseous and central venous drug delivery during cardiopulmonary resuscitation. Resuscitation 2011; doi:10.1016/j.resuscitation.2011.07.041. Research sponsored by Teleflex Incorporated. (preclinical study)
  11.  Philbeck TE, Miller LJ, Montez D, Puga T. Hurts so good; easing IO pain and pressure. JEMS. 2010;35(9):58-69. Research sponsored by Teleflex Incorporated.
  12. Cooper BR, Mahoney PF, Hodgetts TJ, Mellor A. Intra-osseous access (EZ-IO) for resuscitation: UK military combat experience. J R Army Med Corps. 2007;153(4):314-316.
  13. Teleflex Internal Data on File 2018.
  14. Montez D, Puga T, Miller LJ, et al. Intraosseous infusions from the proximal humerus reach the heart in less than 3 seconds in human volunteers. Annals of Emergency Medicine. 2015;66(4S):S47. Research sponsored by Teleflex Incorporated. 
  15. Puga T, Montez D, Philbeck T, Davlantes C. Adequacy of Intraosseous Vascular Access Insertion Sites for High‐Volume Fluid Infusion. Crit Care Med 2016; 44(12):143. Research sponsored by Teleflex Incorporated. Based on healthy volunteer study.
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