PT  - JOURNAL ARTICLE
AU  - Alon Keller
AU  - Amit Boukai
AU  - Oren Feldman
AU  - Raz Diamand
AU  - Itai Shavit
TI  - Comparison of three intraosseous access devices for resuscitation of term neonates: a randomised simulation study
AID  - 10.1136/archdischild-2021-321988
DP  - 2022 May 01
TA  - Archives of Disease in Childhood - Fetal and Neonatal Edition
PG  - 289--292
VI  - 107
IP  - 3
4099  - http://fn.bmj.com/content/107/3/289.short
4100  - http://fn.bmj.com/content/107/3/289.full
SO  - Arch Dis Child Fetal Neonatal Ed2022 May 01; 107
AB  - Objectives To compare the success rates and ease of use of three intraosseous (IO) access devices used in term neonates.Design A three-arm randomised controlled simulation study was conducted.Setting A simulation laboratory.Participants Seventy-two paediatric residents completing their emergency department rotation as part of their residency training, and 20 paediatric specialists.Intervention Using an animal bone model, the one-attempt success rate of the EZ-IO drill, the NIO-I needle and the Jamshidi needle was compared. Uncooked Cornish Hen bones were used because of their similarity in length and diameter to the bones of neonates. Participants were asked to record the perceived ease of use of their assigned device using a 5-point Likert Scale.Main outcome measure The main outcome was the visualisation of flow emerging from the distal end of the bone, and perceived ease of use of the three IO devices.Results The EZ-IO, NIO-I and Jamshidi groups included 30, 31 and 31 participants, respectively, with median (IQR) years of experience of 3 (2–5), 3 (2–6) and 4 (3–5) years. Participants had significantly lower one-attempt success rates with the EZ-IO drill than with the NIO-I and the Jamshidi needles (14 of 30 (46.7%) vs 24 of 31 (77.4%); p=0.016, and 14 of 30 (46.7%) vs 25 of 31 (80.7%); p=0.007, respectively). The median (IQR) ease-of-use score of the EZ-IO drill was higher than that of the NIO-I and Jamshidi needles (5 (4–5) vs 4 (4–5); p=0.008, and 5 (4–5) vs 4 (3–4); p=0.0004, respectively).Conclusions Although easier to use, the EZ-IO drill demonstrated lower success rates than the IO needles in establishing IO access on a neonatal bone model.Data are available upon reasonable request.