FASTResponder can be inserted and used during CPR and does not interfere with other resuscitation requirements.
This device can also be used with a cervical spine collar in place for immobilization. (2)
The device can be inserted through deep skin burns. (3)
The success rates for IO infusion are as high as or higher than for traditional IV infusion. McNabb states “The success rate of vascular access for sternal IO users with training but no previous clinical experience with the IO system was 74%; for those with at least one previous IO device use, 95%…” Median access time for all users was 60 seconds while mean access time was 77 seconds (4) Another study notes first time IO access and infusion success from 80% – 100%, “typically” in 1 minute or less and the majority of IO insertions completed within 2 minutes in all studies. (8)
The flow rate or infusion rate of an IO infusion are comparable to the traditional IV infusion. (8) Flow rates will vary based on a number of factors. The two most important variables are the blood pressure of the patient and the type of infusion system used. Up to 80 ml/minute was achieved using the tradition gravity feed drip system, and greater than 150ml/minute using a syringe bolus technique. (4,11,15)
Any fluids or medications that can be administered by the IV route can be administered IO. (9)
Commonly used medications and fluids used in resuscitation that have been used with IO infusion include but are not limited to lidocaine, epinephrine, dopamine, vasopressin, blood, plasma hypertonic saline, 0.9% normal saline, Lactated Ringer’s, morphine, valium, succinylcholine, heparin, antitoxins and methylpredisolone. (8)
The pharmacokinetics of IO infusion are similar to IV regarding time to enter the vasculature, concentrations in the blood and effects on target organs. (10)(9) With regard to clinically effective doses to target organs, IO infusion is equivalent to or quicker than IV. Note that in cases of severe shock, changes in peripheral venous flow rates make venous access very difficult and may potentially delay the time for medications to reach the target organs by IV. (5)
The paper by Halvorsen states “….a number of studies have indicated essentially identical plasma concentrations or onset of physiologic effects of drugs and fluids when IO infusions were compared to both central or peripheral intravenous infusions…”(7)
The sternal IO procedure is relatively simple and can be utilized by multiple levels and types of medical providers in the pre-hospital and hospital environments.
It has been used by EMT- Basics to EMT paramedics, military medics, nurses, physician’s assistants and physicians. In the pre-hospital environment it provides a safe and quick alternative to the traditional IV. (7,8)
A 93.1% “overall correct use” rate was documented after only a 1 hour lecture followed by 1 hour hand-on practice in a study using EMT-Basic students as the sample group. (12)