Paramedic evaluation of adult Intraosseous Infusion System.

INTRODUCTION: The First Access for Shock and Trauma (FAST 1) Sternal Intraosseous (IO) System is a vascular access device designed as an alternative to peripheral or central intravenous (IV) cannulation for the treatment of critically ill and injured adults. During the development of the device, key objectives included safety, speed of insertion, and ease of use with minimal training. This study evaluated these characteristics.

METHODS: Ten experienced paramedics participated in a 90-minute training program for the use of the FAST 1 System at the Paramedic Academy of the Justice Institute of British Columbia. Then, the paramedics used the system in three simulated prehospital scenarios and evaluated the ease of use and compatibility of the training method with current practice using a 10-centimeter (cm) (3.94 inches (in)), visual analog scale.

RESULTS: The duration of the procedure from opening the package to initiation of fluid flow ranged 52-127 seconds (mean = 92 +/- 32 seconds). Placement accuracy was excellent, with a mean displacement of 2 mm (0.08 in) and 1 mm (0.04 in) in the vertical and horizontal planes, respectively. The paramedics rated the system highly in all areas. They considered the training "straight-forward" and "comprehensive". The possibility for interference between the IO system and cervical collars was reported, and several suggestions to remedy this and achieve other improvements were made.

CONCLUSIONS: Placement of the FAST 1 is fast, accurate, and easy to use. Paramedics had useful input concerning the design of the product.